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ST LUKE'S HOSPITAL - ANDERSON CAMPUS
PATIENT RIGHTS: RESTRAINT OR SECLUSION
Tag No.: A0166
Based on review of facility policy and procedure, review of Medical Record (MR) and interview with staff (EMP), it was determined the facility failed to include restraints on individualized patient plan of care for one (1) out of ten (10) medical records reviewed. (MR1)
Findings include:
Review on January 14, 2025, of facility policy, " Restraint Use " , dated October 2024, revealed, " ...F. Documentation ...k. The patient plan of care will be updated when restraints are applied or removed ... "
Review on January 14, 2025, of MR1, revealed that the use of restraints was not included on the individualized patient care plan while inpatient status from November 29, 2024 to December 2, 2024 for admission beginning November 28, 2024.
Interview on January 14, 2025, at approximately 2:25 PM with EMP1 confirmed the above findings.