Run Restraints Use Audit — Free

Audit Scope and Episode Identification

Resident/patient identifier and audit date are documented

Type of restraint reviewed is identified as physical, chemical, or both

Note (optional)

Relevant charting, orders, and monitoring records were available for review critical (required)

Yes No N/A

Audit episode time frame is clearly defined

Order Documentation and Authorization

Valid restraint order is present in the record critical (required)

Yes No N/A

Order includes indication or clinical rationale for restraint use critical (required)

Yes No N/A

Order specifies type of restraint and conditions for use critical (required)

Yes No N/A

Order start date and time are documented critical (required)

Yes No N/A

Order duration or renewal interval is documented and within policy critical (required)

Yes No N/A

Ordering provider or authorized clinician is identified critical (required)

Yes No N/A

Least-Restrictive Alternatives and Clinical Justification

Behavioral, environmental, or de-escalation alternatives were attempted or documented as not feasible critical (required)

Yes No N/A

Restraint was the least restrictive intervention appropriate to the situation critical (required)

Yes No N/A

Clinical justification describes the immediate safety risk or medical necessity critical (required)

Yes No N/A

Patient/resident rights, consent, or notification requirements were addressed per policy

Yes No N/A

Monitoring, Reassessment, and Safety Checks

Monitoring frequency matches facility policy and order requirements critical (required)

Yes No N/A

Circulation, skin integrity, respiration, and level of distress were assessed and documented critical (required)

Yes No N/A

Vital signs or other required clinical observations were documented when applicable

Yes No N/A

Reassessment for continued need was completed at required intervals critical (required)

Yes No N/A

Any adverse effects, escalation, or complications were documented and escalated appropriately critical (required)

Yes No N/A

Timely Release and Discontinuation

Restraint was released at the earliest safe opportunity critical (required)

Yes No N/A

Release time is documented critical (required)

Yes No N/A

Criteria for discontinuation or transition to less restrictive measures are documented

Yes No N/A

Post-release assessment confirms patient safety and stability

Yes No N/A

Audit Findings and Corrective Actions

Deficiencies or non-conformances identified

Note (optional)

Corrective action plan documented

Inspector signature

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Run: Restraints Use Audit

Audit Scope and Episode Identification

Order Documentation and Authorization

Least-Restrictive Alternatives and Clinical Justification

Monitoring, Reassessment, and Safety Checks

Timely Release and Discontinuation

Audit Findings and Corrective Actions

Get your results