This brings up one of the concepts that I believe will someday be an issue in nursing homes and psychiatric facilities. We all know of physical restraints...Particularly in psych facilities we know of chemical restraints. What about the idea of a psychological restraint? As an extreme example, what if the alarm were loud enough to hurt the residents ears. After a few times of this occuring, the resident would not get out of the chair in order to avoid the noise. I consider that not only a quality of life issue, but a form of psychological restraint. It does in fact prevent the resident from rising, but not in a physical way, but in a psychological one. This is not currently recognized as a restraint, but I believe it will be someday.
Nathan Lake, RN, MSHA
----Original Message Follows---- From: <[EMAIL PROTECTED]> Reply-To: [EMAIL PROTECTED] To: <[EMAIL PROTECTED]> Subject: RE: Clarification on restraints Date: Sat, 10 Jan 2004 11:35:39 -0600 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
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