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MORTON PLANT HOSPITAL
PATIENT RIGHTS: RESTRAINT OR SECLUSION
Tag No.: A0169
Based on clinical record review and staff interviews it was determined that the facility failed to ensure orders for the use of restraint was not written as an as needed (PRN) order for one (#3) of four records reviewed. This practice may cause the use of unnecessary restraints.
Findings include:
1. Patient #3's physician telephone order dated 3/12/10 instructed for bilateral soft restraints as necessary. Interview with Director of Nursing and Director of Patient Care, after they had reviewed the record, on 3/25/10 at approximately 4:30 p.m. confirmed the as necessary order.
PATIENT RIGHTS: RESTRAINT OR SECLUSION
Tag No.: A0171
Based on clinical record review and staff interviews, it was determined that the facility failed to obtain or follow physician orders for use of behavorial restraints for one (#2) of four records reviewed. This practice may cause prolonged or unnecessary use of restraints.
Findings include:
1. Patient #2's physician verbal order dated 3/18/10 at 9:35 a.m. instructed for bilateral wrist and ankle locked restraints for 4 hours with a start time of 9:35 a.m. and a stop time of 1:35 p.m.
Review of the Behavioral Restraint/15 Minute Assessment Record dated 3/18/10 revealed that restraints were initiated at 9:35 a.m. and stopped at 6:15 p.m. The form revealed assessments were documented every 15 minutes from 2:15 p.m. to 6:00 p.m. The documentation showed the patient was asleep. There was no evidence of of the physician being notified for the continue use of the restraints or the physician order to discontinue the use at 1:35 p.m. being implemented.
Review of physician's orders dated 3/18/10 at 10:15 a.m. instructed to loosen the left ankle restraint and administer Geodon Intramuscularly (IM) now for agitation and in 30 minutes discontinue ankle restraints and change to soft wrist restraints.
Interview with Director of Nursing and Director of Patient Care, after they had reviewed the record, on 3/25/10 at approximately 4:30 p.m. confirmed the patient had not been released from restraints at 1:35 p.m., the restraints had not been changed, or the ankle restraints discontinued as ordered by the physician.