Special Care Topics, Volume One

Table of Contents

Forms are listed in Italicized text, and are all included in the companion CD.

Introduction

Restraints   1

Establishing a Facility Restraint Program   1

Policy and Procedure   3

Types of Restraints   5

Side Rails   6

Assessment   8

RAP Guidelines   9

RAP Key and Triggers   13

RAP Module   14

Medical Symptom   15

Alternatives to Restraint Use   17

Monitoring Use of Restraints   19

Potential Negative Outcomes   20

Monitoring Flow Sheet for Restraint Use   21

Checklist for Restraint Use   22  

Care-planning   23

Restraint Care Plan Short Version   25

Restraint Care Plan Long Version   26

Knowledge Deficit, Restraint Use Care Plan   28

Contractures Care Plan   29

Fall Risk Care Plan   30

Consent   33

Emergency Situations   34

Consent Form   35

Quality Assurance   36

Quality Indicator   37

Facility Restraint Program Quality Assurance Audit   38

Restraint Documentation Quality Assurance Audit   39

Facility Restraint Use Quality Assurance Audit   40

Appendix: Revised Restraints Regulations, December, 2006   i

Falls   41

Definitions and Regulations   41

Establishing a Facility Fall Prevention Program   43

Facility Fall Prevention Program Quality Assurance Audit   44

Fall Risk Assessment   45

Risk Factors for Falls   46

Fall Risk Assessment Form   47

MDS Coding   48

Triggers, Guidelines   49

RAP Key   51

Falls RAP Module   52

Restorative Nursing and Therapy   53

Test for Balance   54

Balance and Gait Assessment Short Form   56

Balance and Gait Assessment Long Form   57

Risk Identification Programs and Restraint Use and Falls 58

Fall Prevention Interventions   59

Care-planning   61

Falls Care Plan, Short Version   62

Falls Care Plan, Long Version   64

Knowledge Deficit, Safety Awareness Care Plan   66

Non-Compliance Care Plan   67

Physical Mobility, Ambulation Care Plan   68

Physical Mobility, Range of Motion Care Plan   69

Physical Mobility, Transfers Care Plan   70

Restraints Care Plan   71

Post Fall Assessment and Investigation   72

Quality Assurance   73

Quality Indicator for Falls   74

Falls Log   75

Fall Documentation Quality Assurance Audit   76

Incident Audit   77

Pain   78

Staff Education   79

Resident Pain Care Bill of Rights   81

Internet Links   81

Establishing a Facility Pain Care Program   82

Facility Pain Care Program Quality Assurance Audit   83

Assessing Pain   84

The MDS and Pain Assessment   84

Resident Assessment Protocols and Pain   87

RAP Module for Pain   88

Pain Scales   89

Pain Assessment Terms   91

Qualitative Descriptions of Pain, Nonverbal Indicators of Pain   92

Pain Interview and Assessment   93

Pain Interview and Assessment – Long Form   94

Pain Assessment for the Cognitively Impaired   96

Management and Monitoring of Pain   97

Pharmacological Interventions   98

Potential Side Effects of Pain Medication   98

Non-pharmacological Interventions   98

Pain Flow Sheet   99

Pain Flow Sheet for Cognitively Impaired   100

Pain Medication History   101

Care Plans for Pain   102

Pain Care Plan 103

Pain, Cognitively Impaired Care Plan   105

Knowledge Deficit Care Plan   107

Activity Intolerance Care Plan   108

Insomnia Care Plan   109

Mobility, Impaired Care Plan   110

Mood, Declined Care Plan   111

Pain Medication, Potential for Side Effects Care Plan   112

Gastrointestinal Discomfort Care Plan   113

Constipation Care Plan   114

Quality Assurance   115

References   116