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It all started when Kathy Matthews, an ICU nurse at Mercy Hospital in Detroit, was chided by management for documenting her patient’s restraints ten minutes after the hour one time during her 12-hour shift.

“My manager came up to me the very next shift and said, ‘Kathy, you really should have documented these restraints on the hour, no excuses.’ I told them that I was busy doing compressions on my other patient at the time, but apparently the Joint Commission is doing their best to make sure the nurse is documenting as far away from the bedside as often as possible.”

The next week, one of Kathy’s patients extubated himself while Kathy was busy charting. She filed the incident report, which only took five minutes.

“That was when it hit me. If I document restraints every hour on the hour, and each documentation takes three minutes, then documenting restraints takes me away from the bedside for 36 minutes. Filing an incident report allows me to be at the bedside with my patients over thirty minutes longer. Plus, this frees up more time for me to respond to those emergency situations that used to get in the way of my charting.”

Kathy’s efforts have been applauded by management, as now her restraint charting is the best in the unit, seeing as how she no longer uses them. As a reward, management has put Kathy in charge of all restraint auditing on the unit.

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