Risks and Alternatives of Restraints in Health Care Facilities
Restraints limit a patient’s movement. This brings up many ethical debates and issues. There are certain guidelines that should be followed when it comes to using restraints. It is important to know the different kinds of restraints, how to apply a physical restraint properly and how to administer a chemical restraint safely. It is important to consider alternatives as the use of restraints can present risk and negative outcomes.
History of Restraints Restraints were incorporated into health care many decades ago. “In the late 1970s, more than 25% of U.S residents in long-term care facilities were restrained compared to a current average of 5%” (Taylor, Lillis, Lynn, 2015, p.
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The three categories are physical, chemical, and seclusion. According to Springer (2015), a physical restraint is a device that keeps the patient from moving freely or from the patient harming themselves or other people nearby. Chemical restraints are drugs that are administered that do the same thing a physical restraint does. Seclusion is where a patient is placed in a room by themselves involuntarily and they are not allowed to leave (Springer, …show more content…
“Physical restraints increase the possibility of serious injury due to a fall” (Taylor et al. 2015, p. 707). The patient is also at risk for “skin breakdown, contractures, incontinence, depression, delirium, anxiety, aspiration, respiratory difficulties, and even death” (Taylor et al. 2015, p. 707). “In 1998, The Joint Commission issued a sentinel event alert on preventing restraint deaths, which identified the following risks: placing a restrained patient in a supine position could increase aspiration risk or placing a restrained patient in a prone position could increase suffocation risk” (Springer, 2015, para. 9). In order to reduce these risks the restraint must be applied properly and assess the patient
You may be thinking how did the constitution stop tyranny? Well we have the answer. Let's start of with what tyranny means, that a leader or king abuses their power. How did the constitution guard against tyranny? Well they abuse their power bad deeds. The constitution guard against tyranny in these four ways. Federalism, separation of power, checks and balances, and small states vs. large states.
A reality where the prisoner is dehumanized and have their rights and mental health abused. “I have endured lockdowns in buildings with little or no heat; lockdowns during which authorities cut off the plumbing completely, so contraband couldn’t be flushed away; and lockdowns where we weren’t allowed out to shower for more than a month” (Hopkins 154). A prisoner currently must survive isolation with improper shelter in the form of heat. Issues compound with a lack of running water and bathing, a proven severe health danger, especially for someone lacking proper nutrients such as a prisoner in lockdown. These abuses of physical well being then manifest into damage of prisoners’ mental well being. “Perhaps I should acknowledge that the lockdown-and, indeed, all these years-have damaged more than I want to believe” (Hopkins 156). Even for the experienced prisoner the wrath of unethically long lockdowns still cause mental damage. Each and every isolation period becomes another psychological beating delivered as the justice system needlessly aims to damage the already harmed inmates. The damage is so profound inmates even recognize the harm done to them by their jailors. An armed and widely used psychological weapon, the elongated lockdown procedures decimate mental health each and every time
The 19th century set the stage for different policies that lead to the extending of America’s power, which is defined as imperialism. Imperialism started for different reasons like the Americans wanting the U.S. to expand or explore the unknown land, or even some feared existing resources in U.S. might eventually dry up. The reason imperialism started doesn’t really matter, but more of what it caused. Imperialism lead to Cuban assistance, the addition of Hawaii and Alaska to America, and Yellow Journalism.
Solitary confinement has the ability to shatter even the healthiest mind when subjected to indefinite lockdown, yet the mentally ill, who are disproportionately represented in the overall prison population, make up the majority of inmates who are held in that indefinite lockdown. Within your average supermax prison in which all inmates are subjected to an elevated form of solitary confinement, inmates face a 23-hour lockdown, little to no form of mental or physical stimulation that is topped off with no human interaction beyond the occasional guard to inmate contact. It is no wonder ‘torture’ is often used synonymously to describe solitary confinement. For years, cases arguing against solitary confinement have contested against its inhumane
Seclusion and restraint started out in psychiatric hospitals and have now evolved into many schools. Restraint started out in England in the mid 19th century after having a history of poor conditions. Since Americans did not open up their first state- run mental hospital until 1822, they were unaware of the negative history that happened during the British reformation ("Human Side of Hospitals"). The American physicians thought that the restraints were keeping their patients safe when it was actually mistreatment of their patients. Anything that can be used to restrict the movements of a patient is a form of restraint. Things used as restraints can be leather or velcro wristlets or anklets that are used to hold the patient or attach them to their bed, lock them in their room, or by using sedating chemicals.
Incapacitating agents are methods used to debilitate an enemy force without causing permanent harm. These should not be lethal and should be easily recoverable or treatable. There are two basic types of incapacitating agents; non chemical and chemical. Within each type there are different methods or routes of exposure/effect used to incapacitate ones adversary. Non chemical are auditory and microwave devices. Chemical methods include: olfactory, nerve agents, vesicants, irritants, nausea producing agents, Indole-based Psychedelics, Phenethylamine-Based Psychedelics, Opioids, Dissociative Anesthetics, Tranquilizers, and Anticholinergic Deliriants. The majority of studies is focused in the chemical type as this shows the most promise for success.
Physical restraint, according to Health Care Financing Administration, can be defined as any handling, physical and mechanical methods applied to a patient with the aim of denying him or her the freedom of movement or access to his or her own body (Di Lorenzo et al., 2011). It may involve use of belts or ties that restrain movement of an individual such as seclusion. Seclusion refers to isolation from others, often done in a room that’s I avoid of any furniture and has a small observable window as the only connection to the outside world (Chandler, 2012). The use of physical restraint in handling patients has been on debate for several years now. In most countries such Italy, it
Did you know tobacco and alcohol use cause over 475,000 deaths in the U.S. annually? To assist young people in avoiding these harmful behaviors, the D.A.R.E. program enhances the knowledge and awareness of the hazards regarding dangerous substances throughout a ten week program. The acronym D.A.R.E. stands for drugs, abuse, resistance, and education. D.A.R.E. ensures the safety of adolescents in various situations and instills beneficial strategies, techniques, and tips to aid young people in making responsible decisions.
The study continues on to explain further ramifications, such as, physical effects. This shows some of the devastating effects the practice of administrative segregation has on inmates’ mental and physical well-being. Often, it is the mentally ill that are unfairly subject to this practice. “Mentally ill inmates may find themselves inappropriately placed in administrative segregation because of a lack of other suitable placements, protective custody reasons, or disruptive behavior related to their mental illness.” (O 'Keefe 125). Instead of providing safety to inmates and staff as the prison system claims administrative segregation is for, its main objective is social isolation. Which is one of the harmful elements of AS that makes it torture. Additionally, an annual report from the Canadian Government’s Office of the Correctional Investigator’s states, “close to one-third of reported self-injury incidents occurred in (federal prisons) segregation units”. Therefore, one can infer that the negative effects of AS are contradictory to providing safety to inmates. UN Special Rapporteur on Torture Juan Mendéz proposed administrative segregation should be banned as the “isolation of inmates amounted to cruel, inhuman or degrading treatment or punishment or – in more severe cases – to torture.” The ramifications of administrative segregation amount to what is defined as torture by lawyer and human rights Juan Mendéz. Administrative segregation is an unconstitutional treatment of inmates and does not constitute the values of our society, or the dignity and humanity of all people. Which is contradictory to rehabilitating a person to be physically, socially and mentally restored for reintroduction into society. Its use in Canada’s prison system is unjustified, unethical, and ultimately,
Stewart, D., Merwe, M. V., Bower, L., Simpson, A., & Jones, J. (2010). A Review of Interventions to Reduce Mechanical Restraint and Seclusion among Adult Psychiatric Inpatients. Informa healthcare, 31 (6), 413-424. doi:10.3109/01612840903484113
Intermediate sanctions are a new punishment option developed to fill the gap between traditional probation and traditional jail or prison sentences and to better match the severity of punishment to the seriousness of the crime. Intermediate sanctions served in the community now account for 15 percent of adjudicated juvenile cases (Puzzanchera, Adams, and Sickmund, 2011). All intermediate sanctions are enforced by the United States Criminal Justice System. The main purposes of intermediate sanctions: (1) better match the severity of punishment to the seriousness of the crime, (2) reduce institutional crowding, (3) control correctional costs. Primarily, this is a needed method of punishment to make offenders accountable for the extent of crime and if so let offenders live in their communities to fulfil punishment if not too extensive.
Coercion can be defined as forcing someone to do something they do not want to do. In order to determine if coercion will be successful or not one has to look at four key principles: communication, capability, credibility and compliance or “target will.” While the peace settlements after World War I could have been considered coercive, they probably had very little chance of success based on these four stated principles. France communicated that it wanted unreasonable demands including unlimited reparations for the war. Without Great Britain and the United States, France had little capability in enforcing the settlements. In addition, it had little to no past reputation of being able to support its decision in upholding the settlements. Finally,
The features of enhanced confinement that consistently draw the most profound condemnation revolve around: the often-brutal forms and compassionless deprivations in which these units or facilities operate, the harrowing living conditions that inmates are compelled to endure, the resulting physical and psychological damage to body and soul, and the questionable legality of such confinement. Leading human rights organizations such as Amnesty International and Human Rights Watch are regularly outing the United States for operating torturous prisons that house convicted criminals in the most deplorable and extra-legal conditions. (Marion Experiment pgs.
Of nursing home staff interviewed in 2004, nearly 40% admitted to committing at least one psychologically abusive act toward a resident and 10% admitted to physically abusing a resident in the preceding year.[1] Not only are nursing home residents at risk of being abused by their caretakers but they are also at risk of being restrained, which may lead to a form of abuse. With five percent of the elderly population, or one to two million instances of elder abuse occurring yearly there is no doubt that elder abuse deserves serious consideration.[2]
The reason for selecting this topic is that being an enrolled nurse in an acute mental health inpatient unit for the past 7 years, I have found myself in the situation where I have been a participant in placing a patient in seclusion on numerous occasions and I have conflicting views as to its appropriateness.