The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.
|SPECTRUM HEALTH||100 MICHIGAN ST NE GRAND RAPIDS, MI 49503||April 28, 2016|
|VIOLATION: PATIENT RIGHTS: RESTRAINT OR SECLUSION||Tag No: A0179|
|**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on interview and record review, the facility failed to conduct a one hour face to face evaluation of a patient in restraints, according to facility policy for 1 of 12 patients (Patients #3) reviewed for restraints, from a total sample of 21 patients, resulting in the absence of a thorough assessment of patient #3 while in restraints, which has the potential for unnecessary restraints and the potential for unknown injuries. Findings include:
Review of Patient #3's medical record with Department Database Specialist (Staff C) on 4/28/16 at 1150, revealed a [AGE] year old female who was admitted to the Emergency Department (ED) on 2/29/16 with a chief complaint of telling her parents she had thoughts of harming herself. Review of nursing documentation for Patient #3 revealed she had restraints placed on 4 extremities on 2/29/16 at 0200 for violent behavior. A physician order for the restraints was documented on 2/29/16 at 0234. The first face-to-face assessment by a physician for Patient #3 after the initiation of the restraints was 2/29/16 at 0430.
Review of facility "Restraints: Care of the Patient in Restraints" policy (dated 10/08/2015) on 4/27/16 at 1030, revealed, "The patient must be seen face-to-face by the physician or PA (physician assistant), within 1 hour after the initiation of the restraint...".