Recording use of a restrictive practice on shift

Record every use of a regulated restrictive practice with the time, duration, what happened before, the strategies tried first and the outcome. CompanionAxis checks the use against the current authorisation and flags it if it was not authorised.

Before you begin

• You need the Record restrictive practice uses permission (Team leader, Support worker, Registered nurse and Behaviour support practitioner roles by default).
• The practice is on the participant’s register (see Recording authorised restrictive practices for a participant).
• Record the use as soon as you can after it happened.

Open the form

1. Go to Care → Restrictive practices.
2. Select Record a use at the top right. The Record a restrictive practice use panel opens.
3. Choose the Participant. Only participants with an active practice on the register are listed.
4. Choose the Practice.
5. Read the box under the practice. A green box says Authorised with the expiry and reference. A red box says No current authorisation and that the use will be recorded as unauthorised.

Describe the use

1. Set When. It cannot be in the future.
2. Enter the Duration (minutes).
3. Choose the Worker who used the practice.
4. Fill in What happened and why the practice was used, for example Attempted to run onto road.
5. Fill in Antecedents (what happened before).
6. Under Strategies tried first, tick at least one: Visual schedule shown, Offered two activity choices, Reduced demands and gave space, Offered sensory kit, Moved to a quiet room or Five-minute warning given.
7. Fill in Outcome: how the person was afterwards, any injury and the debrief.
8. Tick Someone was injured if anyone was hurt.
9. Select Save use.

Save use stays greyed out until a practice is chosen and What happened, Antecedents, at least one strategy and Outcome are filled in.

What happens after you save

1. If the use was covered by a current authorisation, you see Use recorded against the authorised practice.
2. If it was not, you see Use saved without current authorisation. It is a reportable incident. and the use opens so you can see why. Follow Unauthorised use of a restrictive practice as a reportable incident.
3. The use goes to review. Reviewers see it in Home → Approvals inbox or in the manager app under Restrictive practices → Uses to review, where they choose Approve or Return.
4. The use appears on the Uses tab, with To report in the Reporting column until it is included in the monthly report.

PRN chemical restraint given through eMAR

1. When a PRN medicine is linked to a chemical restraint practice, record the dose in the medication record as usual. See PRN medication: protocols, administration and follow-up.
2. For high-risk PRN medicines the app asks you to confirm Less restrictive strategies were tried first.
3. The dose is recorded as a restrictive practice use automatically and checked against the authorisation, so you do not record it twice.

Tips

• CompanionAxis decides whether a use was authorised. A use is unauthorised if the practice is not in a current plan, has no current authorisation, has expired, or ran longer than the practice’s maximum duration.
• Select any row on the Uses tab to see the full record: practice, authorisation, duration, worker, antecedents, strategies tried, outcome and injury.
• Filter the Uses tab by Authorised, Type or Participant, and use Export for a CSV.

If something goes wrong

The end must be after the start.

A duration of 0 is rejected even though the hint mentions a single PRN dose. Enter at least 1 minute, or record PRN doses through eMAR.

A use can’t start in the future.

Check the date and time in When.

The participant or practice is not in the list.

Only active practices on the register are listed. Ask your quality team to add the practice through the participant’s plan.

There is no Record a use button.

You need the Record restrictive practice uses permission. Ask your administrator.