5. On Form 408 Nursing Seclusion/Restraint Progress Note, Form 470 Nursing Assessment Protocol for Seclusion and 97% 79% 79% Restraint, and Physician Orders do times match for interventions initiated and time of events? 9. Are details of event similar on all forms without discrepancies 408, 97% 98% 98% 409, and Order sheets? 10. Is Form 470 Nursing Assessment Protocol for Seclusion 96% and Restraint completed? 11. On Form # 407RN 2 Hour Seclusion and Restraint Breaks 2 hour breaks are completed at N/A 100% 100% appropriate intervals and signed by RN? Baseline 1Q 2Q 3Q 4Q Data Elements YTD Target 4Q2016 2018 2018 2018 2018 12. On Form #407RN 2 Hour Seclusion and Restraint Breaks is N/A 100% 100% time ended for S/R completed and signed by RN 13. On Form #407 Seclusion & Restraint Monitoring and Assessment 15 minute checks are completed at appropriate intervals, N/A 100% 100% with Pt’s behavior documented in behavioral terms as it pertains to release criteria, times, dated, and 100% initialed by staff? 14. On Form #407 Seclusion & Restraint Monitoring and Assessment did each staff member N/A 100% 100% that initialed 15 minute checks complete last page of form with signature and title? 15. Were debriefings DB1 & DB2 99% 100% 100% completed at appropriate times? 16. Is patient debriefing in the 89% 100% 100% chart?
5. On Form 408 Nursing Seclusion/Restraint Progress Note, Form 470 Nursing Assessment Protocol for Seclusion and Restraint, and Physician Orders do times match for interventions initiated and time of events? 97% 79% 79% 9. Are details of event similar on all forms without discrepancies 408, 409, and Order sheets? 97% 98% 98% 10. Is Form 470 Nursing Assessment Protocol for Seclusion and Restraint completed? 96% 11. On Form # 407RN 2 Hour Seclusion and Restraint Breaks 2 hour breaks are completed at appropriate intervals and signed by RN? N/A 100% 100% Target Data Elements Baseline 4Q2016 1Q 2018 2Q 2018 3Q 2018 4Q 2018 YTD 100% 12. On Form #407RN 2 Hour Seclusion and Restraint Breaks is time ended for S/R completed and signed by RN N/A 100% 100% 13. On Form #407 Seclusion & Restraint Monitoring and Assessment 15 minute checks are completed at appropriate intervals, with Pt’s behavior documented in behavioral terms as it pertains to release criteria, times, dated, and initialed by staff? N/A 100% 100% 14. On Form #407 Seclusion & Restraint Monitoring and Assessment did each staff member that initialed 15 minute checks complete last page of form with signature and title? N/A 100% 100% 15. Were debriefings DB1 & DB2 completed at appropriate times? 99% 100% 100% 16. Is patient debriefing in the chart? 89% 100% 100%
DDPCQuarterlyReport1Q2018.docx