Implementation Of Physical Restraints And Behavioral Health

b. Restraints should be used as a last resort on patients that are at a high risk for hurting either themselves or others. If this particular hospital is found to be overusing their restraints, they should look into why this is happening and where it is happening most often. What is the patient to staff ratio? Are acuities being considered when staffing the unit? If restraints are being overused, maybe a shortage of staff could be to blame.

As health care workers we are under a legal obligation to protect an individual from any kind of abuse, whether it is physical, financial, emotional, sexual or psychological .Legislation, policies and procedures exist to promote a safer working environment and reduce the potential for risks occurring. They are tailored for the needs of each setting, known and understood by employers and employees and reviewed on a regular basis.

A comprehensive exam response submitted in partial fulfillment of the requirements for the degree of

Any of these issues have the potential to extend the patients length of stay in the hospital. The restraints have the potential to make the patient more agitated, thus increasing his risk of injury. Understanding the nursing-sensitive indicators can greatly contribute to a better outcome for all patients.

The nursing supervisor has multiple issues to address in this scenario, the use of restraints and formation of a pressure ulcer are of a great concern, but I believe these are easily rectified with training and follow-up audits to ensure

My initial problem was my capstone project # 3 on how can a charge nurse help patient 's family cope and avoid the effects of ICU decisions that could lead to post-traumatic stress disorder (PTSD)? I was informed by Dr. Spicer that the initial approval of capstone #3 may have legal consequences per legal department for Kaiser Permanente because of contract issue that would cause further delay in my advancement in the DNP program. He further advised me to contact my academic mentor Dr. Carrion to inquire about changing the approved capstone project. Telephone conference was initiated with Dr.

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.

Restraints prevalence is another NIS that could assist the nurses in the above scenario to identify

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

Patients that we received often wants to either harm themselves or others, and these patients are also considered violent which lead to the frequent use of restraints and seclusion. Using these methods represent a danger to not only staff but also for the patients. Many injuries occur during these confrontations. The need to minimize the use of restraints and seclusion on the unit is necessary for patients and staff safety.

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 authors stated that since they were seeking to t develop a theory of patient advocacy for guidance of nursing research they did not include borderline related, contrary , invented or illegitimate cases. From the above, the authors arrived at three core attributes: 1) safeguarding patients’ autonomy; 2) acting on behalf of patients and 3) championing social justice in the provision of healthcare. It is these core attributes that will be applied to the clinical practice of correctional nursing.

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.

The best part of your decision was not only did you protect your license; you also protected the nurse’s license that made the suggestion. In addition, you found an alternative method to help better distribute the patient assignments and achieve the desired goal. The justification for working out of our scope of practice can be as simple as you said feeling “complimented”, but does not consider safety risk if something goes wrong. Another common hospital practice that places nurses in similar jeopardy is being pulled to a nursing unit deemed comparable. As behavioral health nurses (adult unit), we are required to cover our child and adolescent psychiatric unit (CAPU) when their below their staffing needs. Though all behavioral units have

Every academic discipline in any profession is governed by its rules and policies developed and prone to amendment from time to time after viewing or arises of an issue. Nursing as a profession practice and an academic discipline is however not an exemption to this (Lasater et al., 2015). The nursing practice has different policies governing the procedures, and that promotes health and wellbeing of the patients as well as creating a conducive environment for nurses and the people they interact with in delivery of their services such as medical therapists, technicians, among others (Blegen et al., 2007). These policies ensure that there is a smooth running of the activities for the nurses as well as the patients. There exists a broad array of policies, but in this paper, the registered nurse safe staffing Act system will be looked into particularly in Florida.