Table of Contents
Introduction 1
Establishing a Facility Restraint Program 2
Policy and Procedure 4
Types of Restraints 7
Side Rails 9
Assessment 11
RAP Guidelines 12
RAP Key and Triggers 16
RAP Module 17
Medical Symptom 18
Investigating Underlying Causes of Medical Symptom 19
Alternatives to Restraint Use 21
Monitoring Use of Restraints 23
Potential Negative Outcomes 24
Monitoring Flow Sheet for Restraint Use 25
Checklist for Restraint Use 26
Care-planning 27
Restraint Care Plan Short Version 29
Restraint Care Plan Long Version 30
Knowledge Deficit, Restraints Care Plan 32
Contractures Care Plan 33
Fall Risk Care Plan 34
Consent 37
Consent Form 39
Emergency Situations 40
Quality Assurance 41
Quality Indicator 43
Facility Restraint Program Quality Assurance Audit 44
Restraint Documentation Quality Assurance Audit 45
Facility Restraint Use Quality Assurance Audit 46
Index of Forms 47
References 48
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