Restraint and Seclusion
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BCCNM Limits and Conditions
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1.
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When using restraint or seclusiona interventions, RPNs must follow applicable legislationb specific to their practice setting. |
2.
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When using mechanical restraintc or seclusion interventions with clients certified under the Mental Health Act, RPNs must act with a client-specific orderd from a listed health professional, except in an emergency situation.
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The use of restraint and seclusion is not a restricted activity and is within RPN scope of practice. RPNs may apply physicale and mechanical restraintc and seclusiona interventions.
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a
| Seclusion is a physical intervention that involves containing a client in a room from which free exit is denied (Government of BC, Ministry of Health, 2012, Secure rooms and seclusion standards and guidelines: A literature and evidence review).
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b
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If restraint and seclusion is not done with legislative authority, the act may be an assault. Some examples of provincial and federal legislation which may be applicable to the use of restraint and seclusion are the Residential Care Regulation, Community Care and Assisted Living Act, Mental Health Act, Corrections Act, Criminal Code of Canada and Corrections and Conditional Release Act.
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c
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Mechanical restraint involves the use of devices to partially or totally restrict the client's movements.
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d
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See the scope of practice standard Acting with Client-specific Orders.
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e
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Physical restraint involves direct physical contact that partially or totally restricts the client's movements.
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| Pronouncement of Death |
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BCCNM Limits and Conditions |
1.
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RPNs must follow a decision support tool approved by their employer when pronouncing unexpected death.
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2.
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RPNs must not pronounce death related to medical assistance in dying (MAiD).
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Pronouncement of death is not a restricted activity and BCCNM has no limits or conditions on the pronouncement of death when it is expected/anticipated except when death is related to medical assistance in dying. A pronouncement of death is the process of gathering information about a client’s health status, analyzing that data and making a clinical judgment that life has ceased by observing and noting the absence of cardiac and respiratory function.
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Financial Incapability Assessment – Part 2.1 of the Adult Guardian Act
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BCCNM Limits and Conditions
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1.
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RPNs must successfully complete the educational program titled “A Guide to the Certificate of Incapability Process under the Adult Guardianship Act,” provided by the Ministry of Health.
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2.
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RPNs must follow the guidelines contained in the document “A Guide to the Certificate of Incapability Process under the Adult Guardianship Act,” prepared by the Ministry of Health and the Public Guardian and Trustee of British Columbia.
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| Financial incapability assessment is not a restricted activity. RPNs can conduct the functional component of the assessment to determine incapability for managing financial affairs. |
Incapability Assessment for Care Facility Admission – Part 3 of the Health Care (Consent) and Care Facility (Admission) Act
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BCCNM Limits and Conditions
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1.
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RPNs must successfully complete the the Ministry of Health course, “Consent to Care Facility Admission in British Columbia: A Course for Managers and Assessors";
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2.
| RPNs must follow the Ministry of Health guidelines, “Practice Guidelines for Seeking Consent to Care Facility Admission”.
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Incapability assessment for care facility admission is not a restricted activity, however it is limited by the Health Care Consent Regulation. RPNs are prescribed health care providers under the Health Care Consent Regulation to conduct an assessment to determine incapability for consenting to admission to a care facility.
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