work: Patient Restraint and Seclusion in the Acute Care Setting (PA)

Which of the following is an appropriate use of restraint?

Limiting activity of a violent patient during an episode of acute psychosis

In which setting are restraining techniques more likely o be used?

Under-resourced settings

For adults, what is the maximum time limit for a single order for behavioral health restraint?

4 hours

The evaluation of violent, self-destructive patients who have been placed in restraints or seclusion must occur within:

60 minutes

Which of the following is the best definition of physical restraint?

A device that limits a patient's movements

Who is authorized to re-evaluate a patient who has been placed in restraints or seclusion?

Any of these providers

Which of the following is a true statement/s about restraint or seclusion orders?

B and D

A patient with dementia is displaying increasingly aggressive behavior to a particular staff member, who has become concerned for her safety. Considering only the following choices, which should be done?

C and D

Which of the following is a best practice to help protect the safety and rights of a patient who must be restrained?

Choose the least limiting form of restraint that meets the patient's needs

Which of the following is considered a physical restraint?

Firm grasp from which the patient cannot escape

In which situation must a hospital report a death associated with restraint or seclusion to CMS?

Death of a patient while restrained or secluded

A 78-year-old female patient has been energetic and disruptive. Her continued movements and conversations are distracting and bothersome to the other patients. The nurse has asked that the patient be given a tranquilizer. Should the patient be given the medication?

No

Due to the pranks of a particularly disruptive patient, a state-mandated inspection of a facility was incomplete, which resulted in considerable embarrassment for the attending physician and chief nurse. The inspectors will return the next day to complete their work. The chief physician is considering a request from the business office to confine the patient responsible for the pranks to his room during the inspection. Should the patient be confined during the inspection?

No

Orders for restraint or seclusion may be written on a standing or "as needed" (PRN) basis for:

No patients

Which is the safest way to restrain an aggressive, obese person in a bed?

On his back with his head raised, using a 4-point harness

A patient under the influence of unknown psychoactive drug(s) was involved in a car accident and has multiple lacerations of which he is unaware. He is violent, aggressive, and indifferent to his own safety and the safety of others. Of the following, which would you recommend?

Use physical restraints necessary to immobilize his arms and legs

Which risk is increased when patients are restrained in the supine position?

Taking fluid into the lungs

An adult patient begins to act out. He threatens staff members and other patients. The attending physician tries to address the situation non-physically. Unable to defuse the situation, he decides that the patient must be placed in seclusion. During seclusion, the patient is monitored appropriately. What should happen when the seclusion order expires?

The patient must be re-evaluated for the continued need for seclusion

When is restraint appropriate?

To treat medical symptoms

It is strongly believed that a patient has swallowed an object that may cause internal lacerations. He adamantly refuses to cooperate with the staff who are trying to obtain an X-ray of his abdomen. May he be sedated for the purpose of an examination?

Yes