CNA Chapter 12: Restraint Use Guidelines
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Questions and Answers

When can restraints be used?

Only after less restrictive measures have failed to protect the person and/or others.

Who can order restraints?

Only a doctor/provider.

What agencies set guidelines for restraint use?

CMS, FDA, TJC, State Agencies.

Restraints are NEVER used to?

<p>Discipline, punish, penalize a person/patient or for convenience.</p> Signup and view all the answers

What is an indicator or characteristic of a physical or psychological condition?

<p>Medical symptom.</p> Signup and view all the answers

What is a chemical restraint?

<p>Any drug used for discipline or convenience and not required to treat medical symptoms.</p> Signup and view all the answers

What is a physical restraint?

<p>Any manual method or physical or mechanical device that restricts movement.</p> Signup and view all the answers

What is an enabler?

<p>A device that limits freedom of movement but promotes independence, comfort, or safety.</p> Signup and view all the answers

What are some risks associated with restraints?

<p>Cuts, bruises, fractures, death from strangulation.</p> Signup and view all the answers

What is the most serious risk associated with restraints?

<p>Death from strangulation.</p> Signup and view all the answers

When do you check a resident with restraints?

<p>Every 15 minutes.</p> Signup and view all the answers

How often do you remove restraints?

<p>At least every 2 hours.</p> Signup and view all the answers

What should you report and record if you apply restraints?

<p>Type of restraint, body parts restrained, time applied &amp; removed, skin color, pulse, behavioral changes, and any discomfort.</p> Signup and view all the answers

What are soft and hard restraints?

<p>Soft restraints are made of cloth; hard restraints are made of leather.</p> Signup and view all the answers

Why are restraints used?

<p>To treat a medical symptom or for the immediate physical safety of the person or others.</p> Signup and view all the answers

What is freedom of movement?

<p>Any change in place or position of the body that the person is able to control.</p> Signup and view all the answers

What is a restraint alternative?

<p>The nurse tries to find out what the behavior means and what is causing it to prevent restraint use.</p> Signup and view all the answers

Restraints can be used for staff convenience.

<p>False</p> Signup and view all the answers

Unnecessary restraint is considered false imprisonment.

<p>True</p> Signup and view all the answers

You can apply restraints when you think they are needed.

<p>False</p> Signup and view all the answers

Which is a restraint alternative?

<p>Padding walls and corners of furniture</p> Signup and view all the answers

What should you do to check for snugness of a vest restraint?

<p>Slide an open hand between the vest and the person.</p> Signup and view all the answers

When should you check a person in a vest, jacket, or belt restraint?

<p>At least every 15 minutes.</p> Signup and view all the answers

What is the most serious risk from restraints?

<p>Death from strangulation</p> Signup and view all the answers

Study Notes

Restraint Usage

  • Restraints should only be used when less restrictive measures fail to protect the individual or others.
  • A doctor's order is mandatory for the application of restraints.
  • CMS, FDA, TJC, and state agencies set guidelines for the appropriate use of restraints.
  • Restraints are not permitted for discipline, punishment, or staff convenience.

Types of Restraints

  • Chemical Restraint: Any medication used for discipline or convenience rather than to treat medical symptoms.
  • Physical Restraint: Devices or methods that restrict movement or access to one's body (e.g., clamps, vests).

Enablers vs Restraints

  • Enablers are devices that limit movement to promote independence and safety but can be easily removed by the person, such as lap trays or raised bed rails.

Risks of Restraints

  • Associated risks include cuts, bruises, fractures, and the most serious risk: death from strangulation.
  • Increased use of restraints can lead to confusion and agitation in individuals.

Safety Guidelines

  • Restraints must protect individuals, requiring frequent checks (every 15 minutes) and removal or release at least every 2 hours.
  • Maintain quality of life and follow manufacturer's instructions when applying restraints.
  • Proper reporting includes type, duration, skin condition, and behavioral changes of individuals in restraints.
  • Restraints are considered false imprisonment if deemed unnecessary.
  • Informed consent is necessary prior to applying restraints.

Reporting Requirements

  • Any death related to restraint use must be reported to CMS if it occurs during or shortly after restraint application or removal.

Restraint Alternatives

  • Prioritize understanding and addressing the underlying causes of behavior before resorting to restraints.
  • Techniques such as padding corners and using safe environmental modifications are effective alternatives.

Definitions

  • Freedom of Movement: The ability of an individual to change their body position at will.
  • Medical Symptom: An indication of a physical or psychological condition needing attention.

Instructional Guidelines

  • Always apply restraints as per the manufacturer's instructions.
  • Regularly assess the individual for comfort and proper alignment, especially during restraints application.

Special Restraints

  • Wrist restraints are used to prevent individuals from pulling out medical devices.
  • Vest restraints require monitoring to ensure they are snug yet not constricting.
  • Adjunct devices like roll belts allow limited movement without compromising safety.

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Description

Explore the essential guidelines and regulations surrounding the use of restraints in healthcare as outlined in Chapter 12 of your CNA study materials. This quiz covers important definitions, the roles of healthcare professionals, and the agencies involved in setting these standards. Test your knowledge to ensure safe and compliant practice.

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