Page 39 - Christiana Care Focus June July 2018

Innovation Center. “Agile Development & Operational Efficiency in Health Care.” The Lean Business Transformation & Operational Excellence in Health Care Summit. New Orleans. May 2018.
Stephen A. Pearlman, M.D., MSHQS:
• Gave a workshop on coding in Neonatology. AAP Pernatal Strategies meeting. Scotts, Arizona. April 2018.
• Served on the faculty of the International Conference on Clinical Neonatology in Turin, Italy, May 2018.
Edmondo J. Robinson, M.D., MBA, FACP, et al. “Alleviating Clinician Burnout: The Digital Answer.” AVIA Network Summit: Accelerating Impact. Chicago. May 2018.
Appointments
Vanita D. Jain, M.D. is now the chair of the Society for Maternal-Fetal Medicine coding committee and a member of the Practice Advisory Management Board of SMFM.
Omar Khan, M.D., MHS. Elected to two-year term as president of the Delaware Academy of Medicine (www.delamed.org), May 2018- May 2020.
Denise L. Lyons, DNP, APRN, AGCNS-BC.
Appointed affiliated assistant professor in the School of Nursing in the College of Health Sciences at the University of Delaware, effective from June 1, 2018 - August 31, 2019.
Firas Mourtada, MSE, Ph.D., D.ABR, F. AAPM, has been elected vice president of the Board of the American Brachytherapy Society.
Achievements & Awards
Owen S. Glotzer, M.D., was awarded first place at the Delaware Valley Vascular Society Meeting in April 2018, for presenting “Carotid Thromboembolectomy in the Acute Setting.”
Margaret Lafferty, D.O., received the Thomas R. Boggs, Jr., 2018 Young Investigator Award, presented by the Philadelphia Perinatal Society at the annual
| Extraordinary People Neonatal-Perinatal Research Symposium for
work on a study titled: “Can Mozart Improve Weight Gain and Development of Feeding Skills in Premature Infants?”
James S. Manley, M.D., received the District Service Award at the annual meeting of
The American College of Obstetricians and Gynecologists in recognition of his work in creating instructive videos with Christiana Care residents.
Jon Strasser, M.D., has been appointed to the American Society of Clinical Oncology GI Cancer Guideline Advisory Group (GAG) for
a four-year term and by the American Board of Radiology to join their examination writing committee for thoracic malignancies.
Anthony Sciscione, D.O., received the 2017 Steven Gabbe Award, for outstanding contributions to the Pregnancy Foundation, at the Annual Clinical Meeting of the Society of Maternal Fetal Medicine. 
B E S T P R A C T I C E R E V I E W : Restraints for Violent or . Self-Destructive Behavior
Q. When should restraints be used?
A. All patients have the right to be free from restraints. Restraints may only be imposed to ensure the immediate physical safety of the patient, a staff member, or others and must be discon- tinued at the earliest possible time based on an individualized patient assessment and reevaluation.
Q. Can a nurse initiate the use of restraints without a doctor’s order?
A. In an emergency situation only, the qualified RN may initiate restraints in order to protect the safety of the patient, staff or others. A verbal or written order will be obtained immediately (within a few minutes) after initiation of restraints.
A face-to-face evaluation must be completed within one hour by a licensed independent practitioner (LIP) (attending physi- cian, resident, physician assistant or advanced practice nurse) with the initiation of restraints to determine if other factors, such as drugs, medication interactions, electrolyte imbal- ances, hypoxia, sepsis, etc., are contributing to the patient’s violent or self-destructive behavior.
If you have questions about this Best Practice Review, please contact the Content Expert: Maureen Seckel, Clinical Nurse Specialist 733-6023. Safety Hotline, call 7233 (SAFE) from within Christiana or Wilmington hospitals; from outside call 623-7233 (SAFE).
Q. When must the order for violent or self-destructive behavior restraints be renewed?
A. Orders for restraints are time limited and must be renewed: • Every four hours - Patients 18 years of age and older
• Every two hours - Patients nine - 17 years of age
• Every one hour - Patients under nine years of age
If the need for restraints continues beyond 24 hours, a face to face reassessment must be performed by the LIP prior to writing a new order for restraints.
Q. Can a nurse request a standing order or PRN order for restraints in the event that restraints are discontinued and needed again due to violent or destructive behavior?
A. No, standing orders or PRN orders for restraints are prohibited. If an assessment indicates the need for restraints, a new order must be obtained from the LIP.
Q. When should restraints be discontinued?
A. Once the unsafe situation ends, the use of restraint or se- clusion should be discontinued at the earliest possible time based on an individualized patient assessment and reevalua- tion, regardless of the length of time identified in the order. 
FOCUS • JUNE–JULY 2018 37