HospitalInspections.org

Based on record review, policy review and staff interview it was determined the facility failed to ensure the restraints were used as ordered by the physician for 1 (#3) of 32 sampled patients. This practice does not ensure patients are free from unnecessary restraints.

Findings include:

The facility's policy "Restraint and Seclusion" #PC 027, last revised 3/12, required that orders for application of physical restraint must be for a specific duration, not to exceed twenty-four hours.

Review of the medical record for patient #3 revealed an order for the application of bilateral wrist restraints on 8/18/12 at 10:00 a.m. The ordered time limit was twenty-four hours. The next order for restraints was dated 8/19/12 at 1:45 p.m. Review of the medical record revealed the patient remained in restraints the entire time between the first and second order. The patient was in restraints three hours and forty-five minutes beyond the time limit of the restraint order.

The Chief Nursing Officer was present during the record review on 8/21/12 at approximately 10:30 a.m. an confirmed the staff did not obtain the renewal order within the required time frame.

Based on staff interview it was determined the facility failed to ensure the Emergency Department policies and procedures are reviewed and approved by the medical staff. This practice does not ensure the medical staff is aware of the care provided in the Emergency Department.

Findings include:

The Chief Nursing Officer was interviewed on 8/22/12 at approximately 10:00 a.m. She indicated she could provide no evidence that the Emergency Department policies and procedures were reviewed, revised as needed and approved by the medical staff.