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Compliance em Unidades de Saúde 14 itens

Restraint & Seclusion Compliance Audit

Este checklist está em inglês.

Compliance audit of restraint and seclusion practices covering orders, assessment, monitoring, staff training, and death reporting under the CMS patient rights CoP.

CMS 42 CFR 482.13(e)-(f)CMS 42 CFR 483.12 / 483.10(e)TJC PC.03.05 / PC.03.03

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Least Restrictive & Alternatives

  • Is restraint or seclusion used only when less restrictive interventions have been determined ineffective? *
  • Is restraint/seclusion never used for coercion, discipline, convenience, or staff retaliation? *
  • Is the restraint/seclusion discontinued at the earliest possible time? *

Orders & Assessment

  • Is there an order by a physician or authorized LIP for each episode of restraint or seclusion? *
  • Are PRN (standing/as-needed) orders for restraint or seclusion prohibited? *
  • For violent/self-destructive behavior, do time-limited orders follow the age-based limits (4h/2h/1h)? *
  • Is the patient seen face-to-face within 1 hour by a physician/LIP or trained RN for violent behavior use? *

Monitoring & Care

  • Is the patient monitored/assessed at intervals consistent with policy and the patient's condition? *
  • Are the patient's needs (hydration, toileting, circulation, range of motion, nutrition) addressed? *
  • Is the condition that warranted restraint/seclusion documented and the plan of care updated? *

Staff Training

  • Are staff trained and competency-assessed on safe application and alternatives before applying restraints? *
  • Is training provided on recognizing signs of physical/psychological distress during restraint/seclusion? *

Death Reporting

  • Are deaths associated with restraint or seclusion reported to CMS as required? *
  • Is a log or documentation maintained of restraint/seclusion-associated deaths, including timeframes? *

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