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Use of restraints in healthcare
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The use of restraints is a common practice in acute care and long-term care settings. According to a study regarding the use of physical restraints in 40 acute care hospitals in the United States, the overall rate of restraint use is 50 restrained patients per 1,000 patient’s days; an estimated 27,000 people are in physical restraints each day (Minnick, Mion, Johnson, Catrambone, & Leipzig, 2007). Restraints are often used in hospital settings to keep a person from hurting themselves or doing harm to others. It is also used to prevent falls. Using restraints can cause several problems and adverse patient outcomes. It has been found that physical restraints are associated with increased rates of respiratory and elimination problems, circulation
The prevention of falls in the long term care facility is one of the most important interventions the health care team can do to ensure the safety of loved ones under their care. According to the Summary Data of Sentinel Events Reviewed by the Joint Commission (2016), there were 806 falls between 2004-2015 with 95 of those occurring in 2015 . As health care providers, we have a responsibility to incorporate interventions that will help protect the patient while under our care. Interventions as simple as ensuring the use of a gait belt by any team member that transfers the patient, to making sure all team members are aware of the medications that can make certain patients more of a fall risk, will help in the prevention of falls.
I believe that if you asked a group of people to list off issues regarding an emergency department then they would say long wait times throughout the process and being moved around to different areas of the emergency department. From what I have heard the long waits can be associated with waiting to get back to a room, waiting to see a nurse, waiting to see a doctor, waiting to go to radiology or lab, waiting on results, waiting to be discharged, or waiting to be admitted. All of these things in my opinion add up to one main problem, which is patient flow through an emergency department. In my opinion being able to have a controlled patient flow allows for improved wait times and decreased chaos for patients. So there are a few things
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
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.
Pain is “an unpleasant sensory and emotional experience associated with the actual or potential tissue damage” (“Pain Management Nursing Role”). Pain is categorized into acute and chronic and its management is an integral part of all areas of health care. Pain management is alleviating and reducing pain to a level that is acceptable to the client. Pain is managed with analgesics, or pain killers. One specific When admitted the nurse needs to properly document the patient’s report of pain or oligoanalgesia, or the under treatment of pain could occur. Pseudoaddiction is when a client being undertreated for pain becomes demanding for more medication and seems like he is inappropriately seeking drugs.
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
...l. "[The Use Of Physical Restraints In An Acute Care Hospital]." Assistenza Infermieristica E Ricerca: AIR 23.2 (2004): 68-75. MEDLINE. Web. 22 Oct. 2013.
A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization (Swartzell et al. 2013). Because the multi-etiological factors contribute to the incidence and severity of falls in older society, each cause should be addressed or alleviated to prevent patient’s injuries during their hospital stay (Titler et al. 2011). Therefore, nursing interventions play a pivotal role in preventing patient injury related to hospital falls (Johnson et al. 2011). Unfortunately, the danger of falling rises with age and enormously affect one third of older people with ravages varying from minimal injury to incapacities, which may lead to premature death (Johnson et al. 2011). In addition, to the detrimental impacts on patient falls consequently affect the patient’s family members, care providers, and the health organization emotionally as well as financially (Ang et al. 2011). Even though falls in hospital affect young as well as older patients, the aged groups are more likely to get injured than the youth (Boltz et al. 2013). Devastating problems, which resulted from the falls, can c...
The use of the rigid cervical collar is a practice that was established with a miniscule amount of information backing the overall efficacy of its use. Collars has been is use and relatively unchanged for over 30 years. Overall use of cervical collars is a widely used practice in around 60 countries, and holds the same importance as airway, breathing, and circulation (Sundstrøm, Asbjørnsen, Habiba, Sunde, Wester, 2014). Cervical collars sole purpose was to prevent any further damage from occurring after initial injury and during extrication. Trauma and potential trauma scenes can present a cornucopia of unique and unseen scenarios. In most situation, although there is protocol set in place to first place an individual to hold manual, inline cervical spine, placing a rigid cervical
Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator monitored by the American Nurses Association, National Database of Nursing Quality Indicators and by the National Quality Forum. (NCBI)
Rush, K. L., Robey-Williams, C., Patton, L. M., Chamberlain, D., Bendyk, H., & Sparks, T. (2009). Patient falls: acute care nurses' experiences. Journal of Clinical Nursing, 18(3), 357-365. doi:10.1111/j.1365-2702.2007.02260.x
In an article written by Samantha P. Ziglar, BSN, RN, she describes the main purpose of restraints through her eyes in the medical field. Ziglar states that at least one in every four patients will be restrained at least once, that’s 79.715 million people in the United States (Population). “Specific reasons include fall prevention, limiting wandering behavior and preventing dislodging or interference of therapeutic devices, and controlling violent or agitated behavior” (Ziglar 1). Ziglar emphasises the growing problem among restraints; improper use among nurses. “Patient safety should be every nurse’s top priority; therefore, nurses need to have a thorough knowledge base of the risks and benefits of using physical restraints” (1). As a result of what a nurse needs, restraints are required to succeed in his or her profession, making their patient as safe and comfortable as possible. The purpose of restraints as a whole is to provide patient protection. Ziglar lists the pros and cons of the use of restraints. Some major
Proponents of physical restraint believe that the use of it can assist healthcare providers in treating geriatric patients with conditions ranging from dementia to incontinence. Utilizing medical restraints is necessary for the well-being of patients, as it will be more beneficial for them. However, opponents of physical restraint argue that it causes more harm than good. Along with the physical and psychological trauma that it may bring, it also violates a person's autonomy and decision-making. While the main goal of using restraints is to assist a patient and prevent harm from occurring, the opposite may happen from a mishap by inexperienced or immoral practitioners.
Patient safety is a major issue in health care, especially in the public sector. Studies show that as many as 10 patients get harmed daily as they receive care in stroke rehabilitation wards in hospitals in the United States alone. Patient safety refers to mechanisms for preventing patients from getting harmed as they receive health care services in hospitals. The issue of patient safety is usually associated with factors such as medication errors, wrong-site surgery, health care-acquired infections, falls, diagnostic errors, and readmissions. Patient safety can be improved through strategies such as improving communication within hospitals, increasing patient involvement, reporting adverse events, developing protocols and guidelines, proper management of human resources, educating health-care providers on the need for patient protection, and commitment of the leadership to the task. This paper talks about patient safety and how it can be improved in stroke rehabilitation wards of both public and private hospitals.
After completing my first aid course, I have learned many things that I could put to use if I ever encounter a situation involving life or death. I learned that the first thing to do before performing CPR on an unconscious person is to check, call and care. First of all, I must check for hazards. Next, I have to tap the person’s shoulders and call out to them along with checking for any signs of breathing. If all of a sudden, the person takes a breath, this does not mean the person is conscious; in fact this is a sign of cardiac arrest. Cardiac arrest means that the heart has stopped beating; therefore it cannot pump blood to the rest of the body. Immediately, I have to call 911. If I do not have my phone with me, I must call someone else for help. For example, if I see a person wearing a blue shirt, I must speak boldly: “Hey you, in the blue! There is an unconscious person lying on the ground. Call 911 immediately, and get back to me!” Even though I know that help is on the way, I still need to perform CPR. I can either give two breaths by tilting the head and lifting the chin, or I...