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Restraints and You
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I have a really confused patient!
Describe to me what behaviors you have observed.
The patient ingested an unknown substance at a dance party at 0200 last night.
Someone dropped him off in the parking lot unconscious.
The patient is now pulling at his IV catheter and foley. He is attempting to kick and hit the staff. I am concerned for his safety.
What non-physical interventions have you tried to de-escalate this patient's behavior?
I have attempted diversional activity, verbal instruction, reorientation, environmental modifications...
Comfort measures, closer observation, placed a bed alarm and reviewed medications.
It sounds like it is time to call the doctor.
Hello, this is Dr. Smith, how can I help you?
Dr. Smith, your patient has become violent to staff, is dislodging tubes, and is confused.
Please apply soft wrist restraints for violent self-destructive behavior and give Ativan 2mg IV x 1.
I hope I get my documentation correct!
The intervention guides you on the elements needed for the correct documentation.
The frequency of your intervention is even on the intervention list!
Just follow the intervention to cover the required documentation.
There is even a comments section you can use to "paint a picture" of patient behaviors.
Can I do a trial release when he gets better?
I am afraid not, you must get a new order.
Be sure to monitor the physical and psychological well-being of the patient
Always be sure to use the least restrictive intervention when possible.
It is important to monitor the respiratory and circulatory status, skin integrity, vital signs, and social requirements.
Yes, that will help me identify and respond quickly to signs of physical and psychological distress!
I will add a care plan and monitor for behavioral changes so I can remove the restraints as soon as possible.
Before you know it he will be back to normal!
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