All treatments, equipment, medications, etc. must be documented in the patients’ individualized care plan before being given, placed or initiated. Written orders from the patients’ Attending Physician, Physical Therapist, Nurse Practitioners or other qualified care providers are required prior to the order/placement or initiation of medical equipment, medicines, and other treatments.
When to use:
The use of trays is often medically necessary and prescribed for patients who require:
1) Anterior posture support
2) As an additional support surface for placement/support of flaccid extremities
3) Another support surface to support the weight of a cast, brace or another device
4) Aid in the treatment of conditions that affect the upper extremities such as edema, subluxation, etc.
5) Use of a tray as outlined in the individualized care plan and prescribed by their Attending Physician
6) The tray for assistance in completing their Activities of Daily Living such as feeding, grooming, and other activities
7) Enhanced patient safety following an individualized care plan and the obtainment of a physician’s order
WHEN NOT TO USE
1) Do not use if less restrictive measures are available and will maintain patient safety (CFR 482.13(e)(1) ¹
2) If the patient is left unattended/unsupervised following the placement of the tray
3) If the patient presents a condition that may cause the use of the tray to become unsafe
4) Discontinue use if a patient is at risk of/or begins to slide down and out of the chair while seated
5) Do not use with a patient who is or may become highly aggressive, combative, agitated or suicidal
Broda Tip To Remember:
In the USA, per CFR482.13 (e)(1) ¹, a physician’s order is required for the use of restraints. Also, the individualized care plan must prove medical necessity for the use of restraints and document need for the restraint.
1) Document education and training provided to staff for proper use of the tray
2) Always document observation/safety checks following the placement of the tray
3) Review and document continued need of the tray at each care plan meeting following placement of the tray
4) Always use the tray as ordered and by Facility Protocol, State/Provincial, and Federal Regulations