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.

HILLCREST MEDICAL CENTER 1120 SOUTH UTICA AVENUE TULSA, OK 74104 Oct. 29, 2013
VIOLATION: PATIENT RIGHTS: RESTRAINT OR SECLUSION Tag No: A0168
Based on review of medical records and hospital documents, and interviews with hospital staff, the hospital failed to ensure restraints were:

a. Applied and continued only upon a physician order;
b. Contained the reason the patient was restrained, the type of restraint used, date, time and signature of the physician.

This occurred in seven of nine records (#1, 2, 3, 4, 7, 8, and 9) reviewed where restraints were used.

Findings:

The hospital's restraint policy stipulates that patients are restrained only upon a physician order.

The hospital's restraint policy also follows the Oklahoma State Hospital Licensure Standards, Chapter 667, Subchapter 15-8, which requires, "Orders for physical restraint shall include a statement of reason for the restraint and specify which approved facility methods and devices shall be used."

Record #1 contained a pre-printed restraint order form for the following dates 10/6/13 and 10/7/13. The orders were not complete. The order for 10/6/13 did not contain a physician signature. The order for 10/7/13 did not contain the time the order was written.

Record #2 documented restraints initiated on 10/23/13 at 0530, the preprinted restraint order form was dated, signed and timed several hours later at 1235.

Record #3 contained a pre-printed restraint order form that was not complete. The physician order did not contain the date, time, physician signature and type of restraint used.

Record #4, the medical record documented the patient was restrained everyday form 9/29/13 until 10/4/13. There was no order for 9/29/13 and 10/3/13. The restraint orders dated for 10/4/13 were not complete. There was no documented reason the patient was restrained.

Record #7 the medical record documented the patient was restrained 10/5/13 until 10/9/13 at 2000. There was no order for 10/7/13.

Record #8 the medical record documented the patient was restrained 10/25/13 until 10/28/13. The orders were not complete. The orders for 10/25/13 and 10/26/13 did not document the reason the patient was restrained. There was no order for 10/27/13.

Record #9 documented restraints were discontinued at 1000 on 10/19/13 and restarted on 10/19/13 at 1400. There was no order to reapply the restraint.