HospitalInspections.org

Based on document reviews and interviews, the hospital failed to ensure staff completed restraint training for three (3) out of five (5) nursing staff who were involved in patient restraints in 2023 (for Patients #8, #9, & #10).

Findings:

1. Houlton Regional Hospital's policy titled "RESTRAINTS," last reviewed 06/01/2023 states in part:

" ...Education:
1. Staff must be trained and able to demonstrate competency in the application of restraints, monitoring, assessment, and providing care for a patient in restraint.
Staff must be trained before performing any of the actions specified in this paragraph.
As part of orientation.
Annually for all staff who have direct patient care responsibilities ..."

2. At 3:04 PM on 01/03/2024 an in-person interview was conducted with the Chief Nursing Officer ("CNO") which revealed the following information:

CNO stated that annual Registered Nurse restraint training did not happen in 2023. She stated that due to an error, nursing staff were not assigned to complete annual restraint training in HealthStream (the hospital's online training system). She stated that the last time most of the nurses completed annual restraint training on HealthStream was in 2022.

3. Patient #8's medical record was reviewed and revealed that Patient #8 was placed in soft limb restraints on 03/11/2023.

IT Clinical Analyst confirmed at 8:42 AM on 01/04/2024 that RN #1 was the nurse who applied restraints to Patient #8 on 03/11/2023.

At 8:30 AM on 01/04/2024 CNO confirmed that RN #1 was not current on her restraint training when she applied the restraint on 03/11/2023.

4. Patient #9's medical record was reviewed and revealed that Patient #9 was placed in leather restraints on 04/08/2023.

IT Clinical Analyst confirmed at 8:56 AM on 01/04/2024 that RN #2 was the nurse who applied restraints to Patient #9 on 04/08/2023.

At 8:30 AM on 01/04/2024 CNO confirmed that RN #2 was not current on her restraint training when she applied the restraint on 04/08/2023.

5. Patient #10's medical record was reviewed and revealed that Patient #10 was placed in leather restraints on 08/12/2023.

IT Clinical Analyst confirmed at 8:58 AM on 01/04/2024 that RN #3 was the nurse who applied restraints to Patient #10 on 08/12/2023.

At 8:30 AM on 01/04/2024 CNO confirmed that RN #3 was not current on her restraint training when she applied the restraint on 08/12/2023.