Accuracy Of Restraint

Hospital data on the use of restraint can also be analyzed to improve patient outcomes and satisfaction. This information could be scrutinized to determine if restraints were truly warranted in that particular situation, or if another method could have or should have been utilized first. Documentation should also be examined to determine if the patient was adequately cared for during this time period. In my hospital, the patient must be released from the restraints at least every two hours, and must be toileted at that time. The nurse must also do range of motion exercises with the extremities affected by the restraints. The skin and circulation should be assessed at this time. Every hour, the nurse is required to check the pulses in the extremity affected by the restraint. The nurse’s documentation should reflect that all of these assessments were performed and the appropriate precautions were taken.

A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages from restraining could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). Educating nurses may reduce restraint usage by increasing

J’s scenario is pressure ulcer. From analyzing Mr. J’s case one can see the correlation between the use of restraints and pressure ulcers. Obtaining data listed on the Braden Scale such as moisture, mobility, activity, and nutrition are important when assessing for pressure ulcer risks. Once the collected data indicates the patient is high risk then the established pressure ulcer protocol needs to be followed. Nurses will need to minimize friction, support bony surfaces, manage moisture, and maintain adequate nutrition to advance quality patient care. The other nursing-sensitive indicator in this case is restraints. As I have mentioned earlier the use of restraints in Mr. J’s case seems appropriate as he pose great fall risk which may further complicate his current health condition. However, it is important to perform a complete assessment on the parameters for restraint such as cognitive functioning, history of dementia, physical impairment, and drug interactions to determine the need for restraints. When restraint is clinically indicated, and the benefits outweigh the risks then protocol for restraints has to be followed. Once the patient is restrained, it is standard practice that restraints are to be removed as soon as possible, and the patient in restraints will need assistance to change position every two hours. B) To improve quality patient care throughout the hospital, the quality improvement department should scrutinize, and keep track of the

The Joint Commission also addresses safety issues through the publication and distribution of the Sentinel Event which identifies a severe breach in safety and addresses ways on how to improve processes and to prevent harm in the future. It also publishes the National Patient Safety Goals which address healthcare safety and ways to solve problems that focus on issues such as identifying patients correctly, improving communication among staff, and administering medications safely, just to name a few. “A majority of Joint Commission standards are directly related to safety, addressing such issues as medication use, infection control, surgery and anesthesia, transfusions, restraint and seclusion, staffing and staff competence, fire safety, medical equipment, emergency management, and security. The standards also include requirements for preventing accidental harm; responding to patient safety events; and the organization’s responsibility to tell patients about the outcomes of their care” (TJC,

The following section provides a review of the literature on the use of physical and chemical restraints in long-term care settings as well as potential institutional-level and resident-level factors that influence care practices in long-term care settings.

The NHRA sets the regulations for the use of retraints, in addition to these stated requirements the NHRA calls for an assessment of problematic behaviors, physician concurrence prior to the institution of restraints, use of restraints as a last resort, and explaining the restraints and why it is being used on the resident. The use of restraints is regulated by the NHRA and the practice is discouraged, however a majority of nursing home residents will be subjected to the use of them.

Despite these “rights” nurses in the United States and around the world still use restraints stating the main reason is for patient safety.

This article was selected as it explained and discussed the probable standardized procedure that health care organizations may have to follow for improvements in patient safety. This article explains how the inter-personal and professional relationship of different health care providers need to be maintained for better health care as explained in one of the chapters of health care management.

Each health care employer shall upon request, make available their findings and data for at least 5 years; 5) post a uniform notice that explains the standard and the procedures to report patient handling-related injuries. The notice must explains procedures to report patient handling-related injuries; and explains health care workers’ rights under this Act, including any whistleblower protections. Each health care employer shall conduct an annual written evaluation of the implementation of their programs.

The purpose of this paper is to critique the research article, Mohler & Meyer’s “Attitude of nurses towards the use of restraints in geriatric care: A systemic review of qualitative and quantitative study 2014. The incident I am going to discuss in this paper is of Mr. P., an 85-year-old man, admitted to this facility about 4 months ago. His history includes coronary heart disease, cataract, dementia, hypertension, macular degeneration and Alzheimer’s. Mr P. scored 28 of 30 on the Folstein Mini-Mental State Test, he missed the date and recalled 2 of 3 objects in 5 minutes (Folstein, Folstein, and McHugh 1973). His medications include; Analgesics, antihypertensions, antipsychotics

Physical/manual restraint by a team, mechanical restraint and seclusion should only be used for people detained in a mental health facility under the NSW Mental Health Act 2007 or the Mental Health (Forensic Provisions) Act 1990. If one of these interventions is applied to a voluntary patient, a Medical Officer (M.O.) must assess them as soon as possible after the event to review their status under the Mental Health Act.

After reviewing the Texas Health and Safety Code in regards to restraints in a facility, it is understood that there are many different requirements when attempting to write a policy and procedure. In the policy, the following regulations will be instated, it needs to be known that only trained professionals are allowed to lawfully apply restraints to a person. The restraints used may not hinder the person’s ability to breathe in any aspect or hinder communication. Prior to the use of restraints, first the physician must physically assess the patient before providing an order for the use and thereafter if there is the need to continue the restraints. Once a restraint is applied, a nurse, other than the nurse that applied the restraints, is

and there is a gradual shift from injudicious use to patients being freed from restraints. "Decision-making related to physical restraint use is also influenced by nurse-related factors such as nurses’ perception of patient

While the use of physical restraint on elderly patients is necessary in specific situations, the practice should be very limited at all times. Although it will continue to be used worldwide, measures must be taken by all healthcare providers to gradually minimize the use of restraints in healthcare facilities, reduce the risks that are associated with the practice, offer reasonable alternatives for patient care, and ensure the safety of the patients as well as their caregivers.

A principal difference refers to the use and understanding of restraint in the UK on the one hand and all other countries on the other. In the UK, restraint means only physical restraint, i.e., holding a patient upright or on the floor. Mechanical restraint with belts is considered as unethical and is not in use. In all other countries, restraint means mechanical restraint, i.e., fixing a patient by belts to a bed or a chair or binding arms to a hip belt. The purpose is not only managing aggressive behavior but, in a considerable proportion of incidents, preventing falls in elderly patients. Physical restraint is required outside the UK in an unknown proportion of cases to initiate the procedure of mechanical restraint but is nowhere registered