HospitalInspections.org

Based on a review of the Hospital's restraint policy and the restraint record of Patient #1 it was revealed that for a period of 25 hours the hospital failed to conduct assessments of Patient #1 and to justify keeping him in restraint.

The Hospital Restraint Policy (physical) effective 05/2014 states, in part, " 2. A minimum of every two hours, or more frequently based on the needs of the patient ____, a qualified staff member will monitor the patient and offer/provide the following as appropriate; interventions will be documented on the restraint flow sheet ..., " and " By the nurse: 1. Consideration of least restrictive alternative & response, b. clinical justification for the restraint. "
Patient #1 is an elderly male who was admitted for rehabilitation following a closed head injury. Patient #1 had a tracheotomy for breathing and a Percutaneous Endoscopic Gastrostomy tube (PEG) tube for nourishment.
Patient #1 was assessed as needing non-violent restraints due to attempts to remove his medical devices. A review of his restraint care revealed that on 2/9/2015 Patient #1 was changed from wrist restraint to bilateral mitts which were tied to the bed with 4 side-rails up.
Nursing assessed Patient #1 every two hours as required by hospital policy until 8:00 am on 2/9/2015 but failed to assess him at 10:00 am or at any time up to 9:00 am on 2/10/2015. Therefore, although patient #1 continued in restraint for the next 25 hours, except during rehabilitation, Patient #1 had no assessments related to justification of those restraints.

Based on a review of the Hospital's restraint policy and the restraint record of patient #1 it was revealed that for a period of 25 hours the hospital failed to conduct a range of motion assessment every two hours to patient #1's upper extremities
The Hospital Restraint Policy (physical) effective 05/2014 states in part, " 2. A minimum of every two hours, or more frequently based on the needs of the patient ____, a qualified staff member will monitor the patient and offer/provide the following as appropriate; interventions will be documented on the restraint flow sheet ..., " and, " By the nurse: b. check circulation, skin and muscle condition, adjust restraints as needed ... "
Patient #1 is an elderly male who was admitted for rehabilitation following a closed head injury. Patient #1 had a tracheotomy for breathing and a Percutaneous Endoscopic Gastrostomy tube (PEG) tube for nourishment.
Patient #1 was assessed as needing non-violent restraints due attempts to remove his medical devices. A review of his restraint care revealed that on 2/9/2015 patient #1 was changed from wrist restraint to bilateral mitts that were tied to the bed with 4 side-rails up.
Nursing performed range of motion for patient #1 every two hours as required by hospital policy up to 8:00 am on 2/9/2015 but failed to conduct range of motion for the next 25 hours up to 9:00 am on 2/10/2015. Therefore, although patient #1 continued in restraint, except during rehabilitation, patient #1 received no range of motion every two hours for his upper extremities.