I agree with Nathan. Although we make every effort to not use any side rails, we do run into these types of situations. We are careful to fully educate the resident and/or caregiver on potential negative outcomes and document it well. Thus far it has been adequate. Also, if as things progress you find you need to pad the rails expect the surveyors to question you r/t risk of suffocation. This came up at our last survey. Fortunately for us we had all our eggs in order and all went well.
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nathan Lake Sent: Friday, April 09, 2004 12:56 PM To: [EMAIL PROTECTED] Subject: Re: Side Rails If a mentally sound resident requests restraints for any decent reason, you would be hard pressed to explain why you did not agree to provide them. In this case, there is some risk that is being addressed by using the siderails. Of course there is a risk being created as well. Taking into consideration both the risk being created and the risk being addressed, and the resident's wishes, you must still make a clinical decision. In any case, document discussions with the resident. If you agree to provide the restraint, I would at the beginning, and every time I reviewed the care plan, document that the risk being addressed and the risks being created was discussed with the resident. I would document that the resident states understanding the risks and continues to request the siderails. Nathan ----- Original Message ----- From: "Dorthy Wolfe" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Friday, April 09, 2004 8:31 AM Subject: Re: Side Rails > Thaks, I'm aware of the issues of familey etc requesting restraints and staff wanting them for convenience, but in this case, the res. has spacicity and a hx of seizures. Res is own RP and quite capable of directing own care. > > This is still not an acceptable reason? > > Maybe I'm beating this to death, but this is not a case of placating relatives or making life easy for staff. If I were in Res place and the SR weren't given to me, I'd be calling state to complain that I feel my rights are being violated and I'm in an unsafe environment. > > -----Original Message----- > From: carol maher <[EMAIL PROTECTED]> > Sent: Apr 9, 2004 11:19 AM > To: [EMAIL PROTECTED] > Subject: Re: Side Rails > > See page 3-200 of the RAI manual under the heading "Request for Restraints" : "While a resident, family member, legal representative or surrogate may request that a restraint be used, the facility has the responsibility to evaluate the appropriateness of that requrest, as they would a request for any type of medical tratement. As with other medical treatments, such as theuse of prescription drugs, a resident family member, legal representative or surrogat has the right to refuse treatment, but not to demand it used when not deemed medically necessary. According to the Codee of Federal Regulation (CFR) at 42 CFR 483.13(a). "The resident has the right ot be free from any physical or chemical restraints imposed for the purposes of discipline or convenience and not required to treat the residnent medical symptoms." > > -----Original Message----- > From: Dorthy Wolfe <[EMAIL PROTECTED]> > Sent: Apr 9, 2004 8:03 AM > To: [EMAIL PROTECTED] > Subject: Side Rails > > I'm having a discussion with our PT, who says that a resident's request to have side rails is not reason enough to give the resident side rails. She says there is a reg, but can't produce it. I disagree and say if the resident can verbalize that they want side rails, they can have them. What say yee and is there a reg somewhere I can refer to? > > Thanks, > > Dorothy > > > > > > Dorothy Wolfe, BSN, MDS Coordinator > The Virginia Home > 1101 Hampton St. > Richmond, VA 23220 > Phone: 804-359-4093 X227 > Fax: 804-358-4075 > [EMAIL PROTECTED] > > This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If this message contains protected health information (PHI), it should not be forwarded to any other recipient without the authorization of the original sender and should be encrypted when possible. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. 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For more info visit us at http://www.aanac.org -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/
