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SELECT SPECIALTY HOSPITAL-COLUMBUS, INC
PATIENT RIGHTS: RESTRAINT OR SECLUSION
Tag No.: A0168
Based on medical record review and staff interview, the facility failed to ensure restraint use was in accordance with the physician's order. This affected three of three patients reviewed for restraints (Patients #1, #4, and #7). The facility's census was 71.
Findings include:
Review of the medical record for Patient #1 revealed orders for bilateral soft wrist restraints daily from 06/19/24 at 8:16 AM through 06/24/24 at 6:26 AM and bilateral unsecured/untied mittens from 06/24/24 at 6:26 AM through 07/08/24 at 6:40 AM. The medical record contained documentation on 06/22/24 from 8:00 PM through 06/24/26 at 6:26 AM of bilateral unsecured/untied mittens instead of bilateral soft wrist restraints. The medical record contained documentation on 06/26/24 from 8:00 AM through 07/03/24 at 8:00 AM of bilateral secured/tied mittens instead of the unsecured/untied mittens ordered.
Review of the medical record for Patient #4 revealed orders for a right soft wrist restraint daily from 08/15/24 through 08/22/24. The medical record contained documentation on 08/16/24 from 8:00 AM to 7:02 PM and on 08/19/24 from 8:00 AM to 08/20/24 at 8:00 AM of an unsecured right mitt in place instead of the right soft wrist restraint ordered.
Review of the medical record for Patient #7 revealed orders for bilateral unsecured/untied mittens from 04/30/24 at 12:24 PM through 05/04/24 at 6:44 AM and bilateral soft wrist restraints on 05/04/24 at 6:44 PM through 05/07/24 at 4:00 PM. The medical record contained documentation of bilateral soft wrist restraints from 05/02/24 at 2:11 PM through 05/07/24.
This was verified on 08/22/24 at 1:40 PM by Staff D.
PATIENT RIGHTS: RESTRAINT OR SECLUSION
Tag No.: A0175
Based on medical record review, policy review, and staff interview; the facility failed to ensure the condition of the patient who is restrained was monitored by a physician, other licensed practitioner or trained staff at an interval determined by hospital policy for two of three patients reviewed for restraints (Patient #1 and Patient #7). The facility's census was 71.
Findings include:
Review of the medical record for Patient #1 revealed orders for restraints from 06/19/24 through 07/08/24. The medical record lacked documentation every two hours of safety checks on 06/19/24 from 1:59 PM through 8:00 PM, on 06/23/24 from 3:57 PM through 8:00 PM, and on 06/29/24 from 8:00 AM through 8:00 PM.
Review of the medical record for Patient #7 revealed orders for bilateral soft wrist restraints from 04/19/24 through 04/25/24. The medical record lacked documentation of any safety checks on 04/24/24 from 3:56 PM to 8:00 PM.
Review of the policy titled "Restraints and Seclusion," revised 01/01/24, revealed documentation every two hours of observations of safety, comfort, mobility, skin integrity, food/hydration, and toileting.
This was verified on 08/22/24 at 1:40 PM by Staff D.