This may also include environmental restraints, in which the patient is locked in their room or seclusion from others. These are usually used to prevent patients from injuries sustained from falls or other accidents. Also, it is used to administer treatment when a patient is not compliant with medical practitioners.
This essay will discuss issues that nurses have to consider when caring for a person that either lacks or have compromised capacity. At the same time, the author will explain important terminology in the essay such as the meaning of consent, capacity, best interest, Deprivation of liberty, advanced decisions, risk assessment, including several examples from experience during placement
The use of restraints is seen in the Emergency Department(ED) on a regular bases and has been a new experience to myself as a student nurse. The College of Nurses of Ontario Restraints Practice Standard (2009) explains restraints may be used where patient are at risk to themselves or others, for treatment purposes and controlling behaviours. Restraints may be chemical, physical or environmental. Restraints have limited increase in patient safety and can increase the agitation, confusion and health risks present. In the emergency department majority of bed rails are kept in the up position regardless of the patients’ mental, physical or emotional state. A bed rail is considered an environmental restraint and therefore should be kept in the down
Mental health is defined as an individual’s optimal care in managing the stress of everyday life, through their own unique approach and can efficiently and successfully make vital contribution within the community they live in (Centers for Disease Control and Prevention, CDC, 2013). Since a break in a person’s optimal mental state affects not only the individual but society, it is important to understand what it means to have a break in one’s state of mental health and the different categories that is associated with mental illness. Focus will also be paid to why there is a need for the reformation of the mental health act in Canada; the social determinants that is associated with mental health and their contribution to society’s health’s. Finally, focus also need to be placed on how mental health is being promoted to society the stigma generally associated with it.
Under the Mental Health Act 2014, mental illness is defined as a medical condition whereby thought, perception, mood or memories are considered to be disturbed (Vic, p. 15). But at what point does this Act deem it acceptable to override a person who is experiencing mental illness right to choice around their treatment or freedom? Likewise is the process of a compulsory treatment order or admission as an involuntary patient conducive towards an individual’s wellbeing and recovery from mental illness? This short essay aims to explore these questions through analysing the discourses of care, control and protection. The interventions imposed on the individual of forced medication, restraint and seclusion will be considered within a non-indigenous family context in contemporary Australian mores and norms surrounding cultural perceptions of mental illness and mental health displayed in policy and legislation.
One of the biggest contributors for poor healthcare is the stigma against mental health. This stigma allows healthcare providers to view those with a mental illness as having low relevance, thus creating disinclination towards providing adequate resources and/or care. This negative stance, based on misinformation and prejudice creates those that have a mental illness to lose their self confidence. Because of this loss, people with mental illness decide not to contribute to their health or livelihood. In the past fifty years, many advances have been made in mental healthcare. However, with the attached stigma, many people choose to not seek out treatment.
The mental health act is an act design to protect people with mental illness. It was originally written in 1983 and reformed in 2007. It sets out clear guidance for a health professional when a person may need to be taken into compulsorily detained in a hospital. This is known as sectioning. This helps carers who are unable to cope without help. People can be sectioned if the health care profession thinks they are a danger to themselves, they are a danger to another person or in danger of abuse from another person. The health professionals have a duty of care to the patient who is mentally ill. They must provide get the right treatment and to give them and their families the right information. The act gives rights to
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.
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
Restraints prevalence is another NIS that could assist the nurses in the above scenario to identify
Restraints is an intervention used to confine a person to prevent injury to self or others. Different types of restraints include physical, chemical and seclusion. A physical restraint is anything that prevents the patient from being able to freely move. This can include seat belts, wrist restraints, vests, bed rails, etc. A chemical restraint is using a drug for sedation which also restricts movement or freedom. An example of a chemical restraint can be an antipsychotic. These drugs can be used to reduce anxiety, aggression, and violent behavior. Lastly, seclusion is isolating or confining the patient to a room where they cannot leave. This form of restraint is also to protect the patient from harming them self or others. The use of restraints or seclusion can be a useful intervention if all other interventions have failed. Patients should not be harmed with these restraints so it is crucial they are done properly. Patients who are put in restraints
The Mental Health Act is legislation providing the framework, authority and criteria for people experiencing mental health disorders to be admitted involuntary to a Schedule 1 facility for observation, care and treatment.
Access to mental health care is not as good as than other forms of medical services. Some Americans have reduced access to mental health care amenities because they are living in a countryside setting. Others cannot get to treatment for the reason of shortage of transportation or vast work and household tasks. In some areas, when a
Policies have an important role in regulating and shaping the values in a society. The issues related to mental health are not only considered as personal but also affecting the relationships with significant others. The stigma and discrimination faced by people with mental health can be traced to the lack of legislation and protection of rights (Rodriguez del Barrio et al., 2014). The policy makers in mental health have a challenging task to protect the rights of individuals as well as the public (Swigger & Heinmiller, 2014). Therefore, it is essential to analyse the current mental health policies. In Canada, provinces adopt their own Mental Health Acts (MHA) to implement mental health services. As of January 15, 2016, there are 13 mental health acts in Canada (Gray, Hastings, Love, & O’Reilly, 2016). The key elements, despite the differences in laws, are “(1) involuntary admission criteria, (2) the right to refuse treatment, and (3) who has the authority to authorize treatment” (Browne, 2010). The current act in Ontario is Mental Health Act, 1990.
The world is facing an emergency in the area of human rights in the mental health sector as human rights of the people with mental disabilities have been violating (World Health Organisation). . Many countries in the world and Australia itself have legislation to treat a person with mental illness against his/her wish or without their consent which is the abuse of their basic human rights. The mental health legislation which is called Involuntary Treatment Orders involves treatment and detention of people with mental illness against their wish and it is total violation of the rights of people with mental illness who are subjected to these treatment orders. The United Nations Convention on the Rights of People with Disabilities (CRPD) recognizes that people with disabilities should have freedom from torture and will be given the right to make their own decisions (Barriga, 2013). Therefore, the mental health legislation in Australia also being reviewed by a number of Australian governments in the light of principles set out in UNCRPD (Mcsherry & Wilson, 2015). Consequently, there are some provisions have been made in the recent mental health reform specially to involuntary treatment orders to empower consumers rights which are going to be discussed in the following essay. The Mental health Act 2014 is the major aspect of mental health reform to promote recovery-oriented practice, minimise the use and duration of compulsory treatment, safeguard the rights and dignity of people