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.
|AUSTIN OAKS HOSPITAL||1407 WEST STASSNEY LANE AUSTIN, TX 78745||March 11, 2015|
|VIOLATION: PATIENT RIGHTS: RESTRAINT OR SECLUSION||Tag No: A0168|
|Based on a review of medical records, hospital policies, and staff interviews, the hospital failed to ensure that restraint orders were signed by a physician and that restraints did not exceed 15 minutes.
Review of the Restraint and Seclusion Order for 1/16/2015 revealed that Patient #2 was restrained at 1905 and the time out of restraint was 1923. The order was not signed by the physician as of 3/11/15. The restraint lasted longer than 15 minutes.
Review of the Restraint and Seclusion Order for 1/16/15 at 1925 revealed that Patient #2 was placed in seclusion at 1925 and released at 1935 for continued previous behaviors, aggression towards staff, verbal threats. The order was not signed by the physician as of 3/11/15.
Review of facility policy, Seclusion and Restraint stated, in part, "General Principles ...16. A physician must order each use of restraint or seclusion ...19. Staff members must avoid causing undue physical discomfort and must not cause harm or pain to the individual when initiating or using restraint or seclusion ...
Initiation ...6. If restraint or seclusion was ordered by telephone, the ordering physician must personally sign, time, and date the telephone order within 24 hours of the time the order was originally issued ...
Physician Orders. 1. Original orders - A physician may order restraint or seclusion for a period of time not to exceed: a. 15 minutes for personal restraint; ...
Release. 1. When the individual has exhibited the release behaviors described in the physician's order, the staff member must notify the RN. 2. The RN must evaluate the individual for release based on the individual's current behavior."
The above findings were confirmed in an interview with Staff #2, Risk Manager, the afternoon of 3/11/15 in the facility conference room.