HospitalInspections.org

Based on review of hospital policies, documents and personnel files, and interviews with hospital staff, the hospital failed to ensure staff were trained to:
a. Recognize triggers that might require patient restraints, and

b. Implement restraints safely.

Findings:

1. The hospital's policy documents that the hospital plans to not utilize restraints and seclusion. This was confirmed with administrative staff on the afternoon of 08/08/13.

2. When asked, staff could not tell the surveyors what they would do if an individual could not be redirected or verbally calmed.

3. Staff B told the surveyors that the hospital was considering using the Mandt system as the hospital's approved method if restraints/physical holds were required, but that at present, only Staff C had been trained. Staff C received instructions and certificate to be a "trainer"/instructor in May 2013.

4. Review of nine of nine personnel files (Staff C, D, E, F, G, H, K, L and M) of staff that worked the hospital's geriatric psychiatric unit, showed the hospital has not trained staff and ensured demonstrated knowledge of:
a. Techniques to identify staff and patient behaviors, events, and environmental factors that may trigger circumstances that require the use of a restraint or seclusion.
b. The use of nonphysical intervention skills to deescalate patients and/or situations.
c. The safe application and use of all types of restraints, physical holds, or seclusion that might be utilized if needed.

5. This was reviewed and verified with administrative staff on the evening of 08/08/13.