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Discussion

restraint reduction and fall risks

What is your general acute care community hospital doing to reduce restraint use?

What is your general acute care community hospital doing to reduce falls?

What are you actually doing?

What works?

What does not work?

Does your hospital have any "unofficial" policy on the use of sitters? Some hospitals avoid using sitters and will use restraints before using a sitter but deniy this in thier "official" policy.

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1. We are not allowed to use any form of restraint without documentation from the official guardian and the RMO, combined. A guardian is appointed by the court to represent a person unable to make informed decisions - they are either a family member or from the Guardianship Board.

2. We instead utilise patient care assistants (PCAs) to sit with these ppl, to reduce falls. I think they have to be approved by the chief executive officer of the hospital - it goes way beyond the senior nurses responsible for staffing.

3. We also use a falls risk scale. This is used as legal documentation, and is updated every week, unless there is reason to adjust prn.

Restraints (even the bandaging of a patient's hand to prevent removal of IVs, IDCs, and NGTs) are not allowed legally without prior approval from the above...

  • Experts

Not a direct reply to your ? but a personal experience. I recently underwent surgery, and even after staying longer than I was supposed to, was not in good shape to be navigating on my own. When I finally got the go ahead to take off, I went to the nurses station to call a cab, and was asked about using a wheelchair to get to the hosp entrance. I insisted I could make it on my own, b/c I didn't want to spend another minute there. Luckily I made it to the front door, to the cab, and from the cab, to the inside of my door before I went down. I can't blame the nurses really, because I was insisting that I was ok. They would have really had to assess my ability to walk a straight line to take any other stance. I do believe that they should have insisted on the wheelchair to the hosp entrance though. I thought that was standard procedure everywhere.

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