It is an intervention that is used as a last resort to immobilise a client who is aggressive to self, family, community and or properties. It includes the use of medications or minimal mechanical/physical restraint when medications are not readily available. This can be done with the assistance of family members, community, and or the law enforcement agencies.
Aims
· Prevent injuries to client and others
· Protect properties
· Promote client and community safety
Requirements
1. A Well-Equipped home visit bag including:
· Personal Protective Equipment (PPEs)
· IM/IV Psychotropic/Sedative Medications
· Cotton wool balls
· Syringes and needles
· Alcohol disinfectant
2. Safety box
3. The assistance of staff or other individuals
4. Community Map and or GhanaPost Global Positions System (GPS)
5. Manual/electronic area register/ records of the client
6. Means of Transportation
Steps
1. Read map of the community and identify home of the client
2. Take home visit bag with emergency psychotropic medications
3. Announce your presence, enter on response, greet and introduce yourself to client, family and significant others
4. Ensure privacy and confidentiality
5. Observe the client’s environment for safety and establish rapport (refer to procedure)
6. Enquire from family what precipitated the onset of the client’s aggression or hostility
7. Request for more help and instruct each as to their roles
8. Approach client in a calm, respectful manner to gain his cooperation and enquire what necessitated his behaviour
9. Try to calm client verbally by use of simple and short statements
10. If verbal intervention fail, decide on the mood of restraint
11. Explain to client and family why restrain is necessary
12. Give a cue to the team to approach client simultaneously
13. Approach and immobilize client simultaneously in a semi-circular formation with the blanket by holding client’s clothing at the waist and above the joints of the limbs
14. Speak with client in a firm and calm tone
15. Give client specific and concise instruction
16. Administer emergency psychotropic medications
17. Assess self, client, accompanying staff and others for injury if any
18. Observe client for the effect of the medication and restrain
19. Wash and dry hands/uses hand sanitizer
20. Arrange for transportation to the nearest hospital
21. Document assessment before, during and after the restraint and report findings
22. Congratulate assistants and family members
23. Make follow-up visit if applicable
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