Get the free RESTRAINT SECLUSION FLOWSHEET - Hospital Forms

RESTRAINT / SECLUSION FLYSHEET BEHAVIORAL HEALTH SACS PATIENT IDENTIFICATION DATE: IF INITIAL ORDER, DOCUMENT TIME RESTRAINTS APPLIED: (Military Time) PART ONE: Restraint Seclusion Interventions 1

How to fill out restraint seclusion flowsheet

How to fill out a restraint seclusion flowsheet:

1. Start by writing the name of the patient at the top of the flowsheet.
2. Record the date and time when the restraint or seclusion intervention began.
3. Document the reason for initiating the restraint or seclusion, providing a brief description or explanation.
4. Specify the type of restraint or seclusion used, such as physical restraint, mechanical restraint, or seclusion room.
5. Note the exact time when the intervention was discontinued or ended.
6. Describe the patient's behavior and response during the restraint or seclusion period, including any changes or incidents that occurred.
7. Indicate if any medications were administered during the intervention, specifying the type, dosage, and method of administration.
8. Document any vital signs monitored during the restraint or seclusion, including blood pressure, heart rate, respiratory rate, and oxygen saturation levels.
9. If applicable, record the patient's level of consciousness or sedation scale scores periodically.
10. Make note of any staff observations or interventions provided during the intervention.
11. At the end of the flowsheet, include a signature and credentials of the person responsible for completing the document.

Who needs restraint seclusion flowsheet:

1. Healthcare facilities that provide inpatient or residential mental health services often require the use of restraint and seclusion for patient safety reasons.
2. Psychiatric hospitals, behavioral health units, or specific wards within general hospitals may utilize restraint or seclusion interventions.
3. Restraint and seclusion flowsheets are typically used by healthcare professionals, including nurses, psychiatrists, and other mental health clinicians, who are responsible for monitoring patients in restraint or seclusion situations.

For pdfFiller’s FAQs

What is restraint seclusion flowsheet?

The restraint seclusion flowsheet is a document used to track instances of restraint and seclusion in a healthcare setting.

Who is required to file restraint seclusion flowsheet?

Healthcare providers and facilities are required to file the restraint seclusion flowsheet.

How to fill out restraint seclusion flowsheet?

The restraint seclusion flowsheet should be filled out with details of each instance of restraint and seclusion, including date, time, reason, duration, and staff involved.

What is the purpose of restraint seclusion flowsheet?

The purpose of the restraint seclusion flowsheet is to monitor and track the use of restraint and seclusion to ensure patient safety and prevent abuse.

What information must be reported on restraint seclusion flowsheet?

Information such as date, time, reason, duration, and staff involved must be reported on the restraint seclusion flowsheet.

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