Greetings. This is Gary Klugiewicz.

Tony Pinelle and I just conducted a RIPP Restraint Instructor Class at the Colorado Mental Health Institute – Pueblo (Vistelar provides basic and instructor training for RIPP Restraints).

In this class, a new SR100 Restraint was introduced for use in medical and mental health applications. Check our websites for future classes conducted throughout the country.

Ripp restraint

This CMHIP RIPP Restraint Instructor Class was interesting in a lot of ways. First of all, this class was part of a two week class that began with a Verbal Defense & Influence Instructor Class so that the instructors could mesh their verbal skills with their physical skills.

Secondly, this class was designed for mental health professionals who utilize this restraint training entirely without the use of traditional handcuffs. The restraint system utilizes only soft restraints that use hook & loop material to restrain hands, arms, legs, and other body parts.

This allows for handcuffless ambulatory restraints, as well as full restraints for wheelchairs, restraint backboards, and restraint beds.

We examined the new SR 100 Medical and Mental Health Restraint that has application in restraining a patient’s wrists and ankles as well as enabling the restraint of limbs to backboards.

We also evaluated a new way of “shoulder strapping” a patient to a backboard rather than using the check strap configuration that is usually used. See attached video.

Loading the player for 72MBHffRvZq...

Loading the player for 72MBHffRvZq…

jwplayer(“Player72MBHffRvZq”).setup({
width: “480”,
height: “380”,
autostart: false,
repeat: false,
skin: “http://www.cxl1.net/player/skins/six.xml”,
playlist: [{
sources: [
{
file: “http://gklugiewicz.cxl1.net/u/s/e0b12e45-de48-b06f-87c2-6d9f9aeb42bf.mp4”,
label: “html5”
},
{
file: “http://gklugiewicz.cxl1.net/u/s/dd779029-344a-b291-2a93-9c903daf3900.ogv”,
label: “html5-alt”
},
{
file: “http://gklugiewicz.cxl1.net/u/s/e0b12e45-de48-b06f-87c2-6d9f9aeb42bf.flv”,
label: “flash”
}
],
image: “http://www.cxl1.net/m/i/72MBHffRvZq.jpg”
}]

});

For more information about RIPP Restraints, check out their website at www.rippinternational.com.

It was a pleasure working with both groups of instructors over two weeks in the Interventions for Patients with Challenging Behaviors Instructor and RIPP Restraint Instructor Classes at the CMHIP. It is my hope that they learned as much as we did.

They learned more about our Verbal Defense & Influence & RIPP Restraint training programs while we learned how to incorporate the verbal intervention, containment / stabilization / personal defense, and use of RIPP Restraints into a combined, integrated, smoothly operating system of patient care.

It was a very productive two weeks. Their strategy of using a wide range of staff members to respond to patients in crisis is well thought out, efficient, and effective.

The increased use of the Verbal Defense & Influence Programs to mesh their response between the verbal and physical components of their program and transitioning back from the physical to the verbal mode after the incident will make their program even more effective.

Their continued training with RIPP Restraints will assist their staff even more competently with correctly deciding when it is time to use soft restraints and when it is time to remove them. The training that CMHIP provides in moving from verbal intervention to containment & stabilization with verbalization to restraint with verbalization through removal of restraints with verbalization will make their staff members even more confident in their abilities to control patient behavior at the lowest possible level.

We will be incorporating their use of two communicators while responding to a patient in crisis into our future training programs. The use of one staff member to monitor the patient’s emotional and medical well being while constantly maintaining observation of the patient is brilliant.

The use of a second staff member to supervise coordination of the containment / stabilization will allow for the safety of both the patient and staff while providing for the ability to quickly evaluate and reduce the level of intervention, as appropriate.

Several members commented on their appreciation for the material provided on RIPP Restraint’s List of Identifiable Sign & Behavioral Patterns to assist the staff member at the head monitoring the patient to quickly determine changes in the patient’s physical and emotional state.

Their use of the Tactical Pauses that exist during any conflict situation to allow the patient a second, third, and fourth chance to end the conflict is extremely helpful because it can help to eliminate the “slippery slope” that too often exists in these emotionally charged situations.

The use of containment and restraint can be minimized and even eliminated when the patient has a chance to end “acting out” behavior when staff members periodically ask the patient for their voluntary compliance, cooperation and even collaboration. These questions continue throughout the incident and can assist in ending the episode at the lowest possible level of containment / stabilization / restraint.

Finally, we reviewed the First Responder Philosophy that CMHIP utilizes in planning their response to emergency situations. I love the large FRP Chart posted in the training room along with the small FRP Flyer posted on the wall of the classroom. See attached FRP.

Loading the player for 8mdXSwBmK...

Loading the player for 8mdXSwBmK…

jwplayer(“Player8mdXSwBmK”).setup({
width: “480”,
height: “380”,
autostart: false,
repeat: false,
skin: “http://www.cxl1.net/player/skins/six.xml”,
playlist: [{
sources: [
{
file: “http://gklugiewicz.cxl1.net/u/s/72a996e5-2f26-7d82-7744-d74ba1da6fd7.mp4”,
label: “html5”
},
{
file: “http://gklugiewicz.cxl1.net/u/s/72a996e5-2f26-7d82-7744-d74ba1da6fd7.ogv”,
label: “html5-alt”
},
{
file: “http://gklugiewicz.cxl1.net/u/s/72a996e5-2f26-7d82-7744-d74ba1da6fd7.flv”,
label: “flash”
}
],
image: “http://www.cxl1.net/m/i/8mdXSwBmK.jpg”
}]

});

One of the main takeaways from our training was the need to spend more time debriefing situations. Documentation / Debriefing is the 10th component of the FRP.

We should reinforce with staff members the importance of providing a debrief with the patient, the patients witnessing the event, the staff members responding to the incident, staff members relieving the staff member who responded to the initial incident, and to the all members of CMHIP based on the seriousness of the incident.

Although this debriefing takes time, debriefing improves future performance and should be practiced after emergency situations. Please continue to watch www.vistelar.com/blog for additional blog entries.

 

Vistelar Group –