b'Assessment and Reassessment The training/competency (CPI certification/module or Annual R/S/ Module) is provided, but not limited to Always assess and reassess patients condition within appropriate intervals as per policy. Clinical RNs, LPNs/LVNs, and EMTs Document a clinical notification for any changes inCare Assistant Level IIpatients condition, abnormal lab results obtained, or painSecuritymanagement. Identified Urgent Care Center personnelClarify that there is a specific instruction for any PRNInpatient Psychiatry Unit personnelorders for one or more medications with the same reasonMedical Stafffor administration.What is Seclusion?Behavioral Health -Seclusion is the involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving. Seclusion use is Medical and Behaviorallimited to the Inpatient Psychiatry Unit only.Restraints Seclusion or restraint shall be used only in emergency situations:Suicide is the second leading cause of death for children,When necessary to prevent a person from seriously adolescents, and young adults aged 15-to-24-year-oldsinjuring self or others(AACAP, 2108). It is estimated that 49-65 hospital suicidesLess restrictive techniques have been tried and failed.occur each year; 75 to 80% were psychiatric inpatients (AHA, 2018). Designated staff training is part of orientationIf it has been clinically determined that the danger is of and on an annual basis. such immediacy that less restrictive techniques cannot be safely applied Nurses promote and advocate for the protection ofThe patient shall be released from seclusion or restraint patients from harm and from the potential for harm thatas soon as he or she is no longer an imminent danger to could result from the use of physical restraints. Whileself or others.patients may be restrained to prevent them from harmingAn order for seclusion or restraint must be obtained from themselves or others, this practice could result in patienta Licensed Practitioner (LP) who is permitted to order harm-(ANA, 2020) seclusion and restraint on a patient.What is a Restraint?First Time Non-Violent Medical Restraint:A restraint is any manual method, physical or mechanical device, material equipment that immobilizes or reducedIt must be ordered by a LP.the ability of a patient to move his or her arms, legs, body,Entered as an order for Restraints Initiate for non-or head freely. Violent BehaviorChemical restraints a drug or medication when it isWill expire 23:59 hours from the initial order timeused as a restriction to manage the patients behavior or restrict the patients freedom of movement and isFor Continued Need of Non-Violent Medical Restraints:not a standard treatment or dosage for the patientsA LP must order Restraints Continue for Non-Violent condition. Behavior within 2 hours of expiration timePhysical restraints are by manual method or physicalA face to face examination of the person medical and or mechanical.behavioral condition will be conducted within 1 hour A trained registered nurse or staff member in seclusionby the providerand restraint procedures may initiate seclusion or restraintNOTE: Patient on restraints for more than 7 days are in an emergency when danger to oneself or others inconsidered prolonged restraints and other measures/imminent.assessments must be documented if restraints are to be continued.38 Nicklaus Childrens Health System'