> Depends on how you write your orders. I would have written that the lap tray was a
> positioning device to prevent forward sliding of hip secondary to lack of lower
> extremity strength due to ??. Care plan the table as an activity.
Davina DeMerritt, RN
> From: "Holly Sox, RN, RAC-C" <[EMAIL PROTECTED]>
> Date: 2003/12/03 Wed AM 09:48:38 EST
> To: <[EMAIL PROTECTED]>
> Subject: Restraints? Survey question, of course
>
> Hi, Group!
> Survey team leader was asking about a resident with potentially double restraint. I
> have not coded this resident as having a trunk restraint. He has virtually no
> voluntary movement in his lower extremities and very poor balance and safety
> awareness. He has a lap tray when he is up in his chair, because otherwise he
> slides out. It is not restricting any access to his body, at least not in my
> opinion. He does flail his arms and hands at times, reaching and grabbing at
> others, and punches/hits at times. He has an order for soft wrist restraints during
> care, which are used only if he is combative, and this is addressed and care planned.
>
> The double restraint issue has sprung from a table that activities has set up for
> his use in the dining/activity area. It is a half-circle table, that he is placed
> behind with a "busy box" of toys and things to play with. He is able to reach and
> grab and play without the chance of harming others. We still use the lap tray
> because the table does not prevent him from sliding out of the chair.
>
> So, is there anyone (or more than one) out there who can give me some guidance on
> this? He seems truly happy when he is up at the table, and is able to
> interact/socialize with other residents and staff safely. I can't see removing the
> lap tray. The lap tray alone is not enough of a barrier to keep him from hitting
> others. If the lap tray is truly a restraint, then is there ever a situation where
> a double restraint is acceptable? Is there any documentation of this?
>
> Thanks!!
> Holly F. Sox, RN, RAC-C
> Clinical Editor, Careplans.com
> www.careplans.com [EMAIL PROTECTED]
>
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
