MDS Alert

Question: One of the residents at my facility recently had a tracheotomy and is restless and constantly trying to remove the tube. His care plan includes trach care, but I don’t know how to assess the mittens. He can still move his arms and hands; the mittens really only affect his use of his fingers. Do the mittens qualify as a restraint per Section P?

Montana Subscriber

Answer: Yes, according to the RAI Manual, if the mitten use is within the seven-day lookback period.

If your resident is using the mittens all the time within the lookback period, you’ll need to make note of it twice during your respective assessment and on the MDS, in item P0100 (Physical Restraints). You should choose Code 2 for both C. limb restraint used in bed and F. limb restraint used in chair or out of bed.

If the resident’s mitten use isn’t within the lookback period of the MDS assessment, you still have to document the use of the physical restraints. Don’t forget that you must care plan the use of mittens — restraints —  for this resident, with a particular focus on “preventing the adverse effects of physical restraint use,” the RAI Manual says on page P-2.