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SELECT SPECIALTY HOSPITAL-COLUMBUS, INC

1087 DENNISON AVENUE, 2ND FLOOR

COLUMBUS, OH null

PATIENT RIGHTS: RESTRAINT OR SECLUSION

Tag No.: A0168

Based on medical record review, staff interview, and policy review, the facility failed to ensure the use of restraints were in accordance with the order of a physician or other licensed practitioner for five of six medical records reviewed for restraints (Patient #1, #2, #5, #6, and #7). The total sample was ten. The facility census was 76.

Findings include:

1. Review of Patient #1's medical record revealed orders for bilateral wrist restraints on 07/06/22, 07/07/22, 07/08/22, 07/09/22 and 07/11/22. Review of the flow sheet revealed bilateral wrist restraints applied on 07/10/22. However, there was no order for bilateral wrist restraints to be applied on 07/10/22.

2. Review of Patient #2's medical record revealed physician orders for non-violent restraints on 07/17/22 and 07/19/22. Review of the restraint flow sheets revealed on 07/18/22 at 8:00 AM the patient had on bilateral wrist restraints. There was no order for the 07/18/22 restraints.

3. Review of Patient #5's medical record revealed the physician wrote orders for non-violent restraints on 08/17/22 and 08/19/22. Review of the restraint flow sheets revealed on 08/18/22 at 8:00 AM the patient had on bilateral wrist restraints. There was no order for the 08/18/22 restraints.

4. Review of Patient #6's medical record revealed the physician wrote orders for non-violent restraints on 08/24/22 and 08/27/22 through 08/31/22. Review of the restraint flow sheets revealed on 08/25/22 at 8:00 AM the patient had on bilateral wrist restraints. There was no order for the 08/25/22 restraints.

5. Review of Patient #7's medical record revealed the physician wrote orders for non-violent restraints on 08/15/22, 08/16/22, 08/17/22 and 08/19/22. Review of the restraint flow sheets revealed on 08/18/22 at 8:00 AM and at 8:00 PM the patient had on either bilateral or left wrist restraints. There was no order for the 08/18/22 restraints.

Staff A verified the above findings in an interview during record review on 08/31/22 at 10:30 AM. Staff A stated restraints orders were good for 24 hours and new orders should be placed daily by the physician.

Review of the agency's policy titled, Restraints and Seclusion, issued on 12/01/98, revealed restraints must be ordered by a physician. Orders for restraints must be renewed on a daily basis.