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How can health care facilities reduce the use of physical and chemical restraints without sacrificing the quality of care they provide? This creative, practical book presents innovative ideas for improving the quality of life of patients and residents as it details how to: create and implement a safe restraint reduction program; determine how to begin the restraint reduction process with each resident; allay the fears of staff, families, and residents about restraint removal; and develop effective alternatives to restraints. Written by nationally recognized leaders in the field, "Toward a Restraint-Free Environment" helps health-care providers transform their approach to care by laying the foundation for a successful restraint reduction program, and, more importantly, a restraint-free environment.
The aim of this project is to be able to improve patient safety by minimizing the inappropriate use of physical restraints from 45% to about 20% in the acute respiratory unit which caters to patients with acute respiratory issues, such as exacerbation of chronic obstructive pulmonary disease (COPD), patients with new or old tracheostomy, needing bipap, rigorous nebulizer treatment, and other respiratory-related devices, not to mention the multiple comorbidities that oftentimes very difficult to stabilize which makes the hospital stay longer than usual. The Clinical Nurse Leader (CNL) as an educator and an outcome manager is an agent to empower the staff to think critically as well as to reflect on their values and behavior prior to the application of restraints, in promoting a safe and compliant environment to all the patients, health care providers, and families. A fishbone diagram, SWOT analysis was conducted, one on one teaching and in-services were provided due to budget constraint. A PowerPoint presentation was presented to those who have the time to listen and it will be sent to the Education Department to include in the MyJourney online class annually. The distribution of handouts, communicating with the stakeholders regularly, and posting information on the board such as the policy and procedure of the physical restraint for review purposes was utilized as well. Currently, the nurses are more diligent in using physical restraint. Physicians even spend time to assess the appropriateness of the restraints. I am hoping that this project will be able to be implemented in the macrosystem so that in the near future, we can strive for a restraint-free hospital.
In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.