Then
the situation of a resident with an alarm sounding, repeatedly told to sit down,
is not a restraint but probably a quality of life issue.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED]
Sent: Saturday, January 10, 2004
10:51 AM
To: [EMAIL PROTECTED]
Subject: Re: Clarification on
restraints
Bed and chair alarms and other
wanderguard systems are not restraints according to the RAI manual
definition. The following Q&A was part of the Q&A set from CMS in
May 2002.
"5-89. Please clarify the use of chair and bed alarms. Example: Resident
placed in chair with chair alarm, resident stands up and attempts to ambulate
and alarm sounds. Staff intervenes and places resident back in chair every time
alarm signals. This seems to be restricting movement. Is this then considered a
restraint?
"The alarm is not restricting the resident’s freedom of movement.
Unless the attachment of the alarm cannot be removed easily and restricts the
resident’s freedom of movement or normal access to one’s body, the
alarm device would not meet the definition of a restraint. In either case,
there is not a category on the MDS 2.0 to code chair or bed alarms. The use of
these devices should be documented on the medical record and in the care
plan."
Although this explanation hasn't made it into the RAI User's Manual, there is
no reason to believe that CMS' position has changed. I believe that
wanderguard systems would fall into this same category.
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: Re: Clarification on restraints
Date: 1/9/04 8:08:04 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
We
did recieve a tag regarding Wandergaurd bracelets one time because she had not
been assessed for restraint reduction..it was considered a restraint because
she was unable to remove it
I
think if one physically makes a person sit down after an alarm sounds then they
have just been restrained and there should be a place to code such because
residents are physically restrained in such manner daily
-----
Original Message -----
From: sheppard70057rn
To: [EMAIL PROTECTED]
Sent: Friday, January 09, 2004
6:47 AM
Subject: Fw: Clarification on
restraints
Dawn Sheppard, RN, CRNAC
----- Original Message -----
2 areas come up frequently as a question that I cannot find
on the CMS site-
1. chair alarms and bed alarms- are they restraints? we heard
at an MDS seminar in Texas that a resident who gets conditioned to the sound of
the alarm and sat back down when the alarm sounded-we would have to code as a
restraint-
2. wander guard bracelets-are they restraints? although the
resident is free to move within the facility- it does prevent them from
leaving-so how would we code those?
Here are two questions that have been posed to me. The
first one I would not believe it is a restraint but the second one gets you
wondering. Here is the thing: IN the definition in the RAI manual
about restraints it states "restricts freedom of
movement". What is freedom of movement? Because
technically a wanderguard would restrict freedom of movement from inside to the
outside. But if you are saying freedom of movement of their body then no
it does not restrict that. BUT if that is what it means thenit brings you
to siderails. Siderails just restrict movement from one surface to
the next, they do not restrict the resident's freedom of movement of their
body.
Any comments are greatly apppreciated.
Dawn .
