Re: Conference plus question

[RRS2000]

Bed rails of any type should be coded as restraints only if they meet the definition of a "restraint" as outlined in the RAI User's Manual.  In that definition, it is only the effect the device has on the resident that determines if it is a restraint - it doesn't matter what you use it for or what you call it.  If the side rail prevents the resident from doing something he or she could do if the side rail wasn't there, or if it prevents the resident's access to his or her body, then it is a restraint.  If it does not prevent the resident from doing something he or she could do if the side rail wasn't there and doesn't restrict the resident's access to his or her body, then it is not a restraint.  See page 3-202 of the RAI User's Manual.

As I understand the case described in the e-mail, the resident has no movement and therefore the device is not preventing him from doing something he could otherwise do.  In that case, the side rail is not a restraint.

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]

We use half
side rails on resident's with PEG tubes due to the increased risk for them
sliding sideways out of bed and due to the risk for involuntary movements,
(due to the need for elevation of the HOB >45*) I have always coded this in
section P4b due to the definition of side rails. I am now being told that
they are not to be coded in such a way. (My DON is an ex-surveyor) and she
says the surveyors will not "nail" us due to the use if they are used in
this fashion. I feel that even though the resident has no voluntary movement
and we use them for "bed boundaries" we still need to code them as they are.
What do you all think? Am I over thinking this or what? Any help would be
greatly appreciated. I am prepared this morning to show them the RAI
definition and would like a little more back up to present to the DON.
Thanks in advance!
Pam