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Lexington City Schools Physical Restraint Documentation Form Complete and sign the documentation form immediately following physical restraint. Keep the documentation form with the students discipline.

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Patients in medical/surgical restraint will be continually assessed for the opportunity for removal of restraints. This re-assessment should be documented at least every 4 hours.

Documentation must reflect the date and time the restraint is applied, the type of restraint, alternatives that were attempted (including their results), and notification of the patient's family and physician.

Monitoring / Care of patient The patient will be observed at least every two hours (or more frequently based on assessed needs). Direct continuous observation is required. (i.e., a sitter at bedside). In-person assessments must be documented every 10 to 15 minutes, with no time lapse of greater than 15 minutes.

The patient restrained for the management of violent or self-destructive behavior will be under continuous observation with documentation by a NA/Sitter of patient activity every 15 minutes. Nurse will document a nursing assessment to include respiratory status, circulatory status, range of motion, and behavior.

Documentation patient behavior that indicates the continued need for restraints. patient's mental status, including orientation. number and type of restraints used and where they're placed. condition of extremities, including circulation and sensation. extremity range of motion. patient's vital signs. skin care provided.

Orders for restraints are renewed every 24 hours after evaluation by the provider. All patients with restraints require documentation at least every two hours, and require continuous monitoring.

Reassess and document every 15 mins if Violent/Self-Destructive Restraints are still needed. Reassess and document every 2 hours the patient for circulation, skin integrity, range of motion, hydration, nutrition, elimination, and injuries.

The patient restrained for the management of violent or self-destructive behavior will be under continuous observation with documentation by a NA/Sitter of patient activity every 15 minutes. Nurse will document a nursing assessment to include respiratory status, circulatory status, range of motion, and behavior.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232