The use of physical restraint is quite common among caregivers in health facilities when dealing with geriatric patients. Yet this topic is one of the most debated issues in healthcare and medicine. The purpose of medical restraints is to prevent patients from harming themselves or those around them. It seems to be a simple solution and panacea for unruly patients who needs to be treated. However, ethical implications surround its usage as the practice of physically restricting people strips them of their autonomy as well as other psychological factors, such as agitation and trauma. Therein lies the dilemma on how to approach such an issue.
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.
To improve the understanding on this topic, background information must be supplemented. According to the State Operations Manual Appendix PP of the Centers for Medicare and Medicaid Services (CMS), or formerly Health Care Financing Administration (HCFA), the term physical restraint is defined as “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the in...
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...L. B., and M. Cullinan. "Frequency of Assault and Severity of Injury of Psychiatric Nurses in Relation to the Nurses' Decision to Restrain." CINAHL Plus with Full Text. EBSCO, Aug. 2011. Web. 21 Nov. 2013.
Rutledge, Dana N., and Eliza Schub. "Restraints: Minimizing Usage in Skilled Nursing Facilities." CINAHL Plus. EBSCO, 7 June 2013. Web. 18 Nov. 2013.
"State Operations Manual: Appendix PP." CMS.gov. Centers for Medicare & Medicaid Services, 10 Jan. 2011. Web. 18 Nov. 2013.
Tzeng, Huey-Ming, and Chang-Yi Yin. "Physical Restraint Use Rate and Total Fall and Injurious Fall Rates: An Exploratory Study in Two US Acute Care Hospitals." Open Journal of Nursing 2.3 (2012): n. pag.SCIRP. Scientific Research Open Access, July 2012. Web. 20 Nov. 2013.
Veer, A. J. E., Anneke L. Francke, Rian Buijse, and Roland D. Friele. Nursing Journal. Wiley, 2009. Web. 18 Nov. 2013.
This assignment will explore a case study on an episode of care where a patient with chronic pain was hoisted. This will be written from the perspective of the author, a student nurse. The purpose of this assignment is to underline the ethical, legal and professional issues surrounding the episode of care during nursing practice and how these issues influence the role of the nurse and their professional judgement in delivering holistic, person-centred care for the patient. The author will cover the complications on delivering care when healthcare professionals should consider and respect the patient’s decisions and personal preferences whether it may benefit the patient or not. Therefore, the author will argue the principles of the patient’s autonomy against the concerns for the patient’s health and well-being, considering what form of care is appropriate and what must be done and how the nurse can maintain their professional role in being an advocate. Moreover, this will consider the nurses’ approach in providing the best care possible by means of ethical, legal and professional values. Furthermore, this assignment will briefly show an awareness of the roles of other professionals involved in the care.
As population ages, clinicians will care for an increasing number of elderly patients. Just as these patients may present unique and challenging medical dilemmas, so may they also present ethical ones. Ethical dilemmas are present in everyday practice. It provides a brief overview of the situations that may raise ethical concerns. Although, these are not the only ethical concerns that may arise during care of the elderly and are not unique to the population, they represent the most common scenarios that clinicians may encounter in their everyday course of practice. Ethics, according to (Mueller, Hook & Fleming, 2004), is the analysis and identification of the moral problems that arise in the care of patients. Ethical issues on geriatrics: a guide to clinicians (2004) reports that clinicians will care for an increasing number of elderly patients with challenging medical problems.
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.
Policies and procedures are guidelines instructing service providers to ensure compliance with laws and regulations, and have a responsibility for safe guarding. A set of policies are guidelines formulated by an organization to reach its long-term goals, which according to the multi-risk agency team is to protect and prevent adult’s from abuse and neglect. Establishing multi-agency safeguarding, sharing information amongst the allocated healthcare professionals suited to a case, in a multi-disciplinary meeting, to identify signs of abuse and provide justice to victims who confide in the multi-risk agency team. This meeting consists of a range of professional opinions, and the patient’s intel on the situation and their conclusion, the patient
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
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
Wilson, Ronald W. and Elmassian Bonnie J., The American Journal of Nursing , Vol. 81, No. 4 (Apr., 1981), pp. 722-725
Nursing/Academic Edition. Web. The Web. The Web. 01 Apr 2014.
In 2001, over 450 million people worldwide suffered from mental illness (World Health Organisation, 2001) and these numbers have increased by a wide margin since then. Using restraints in treatment for those who are mentally ill is a topic that creates a large amount of controversy. Many are concerned with how the use of restraints can affect the person and if they are necessary or if alternative measures could be used. The National Alliance of Mental Illness has indicated their position on restraints, “The use of involuntary mechanical or human restraints or involuntary seclusion is only justified as an emergency safety measure in response to imminent danger to a patient or others.” (The National Alliance of Mental Illness, 2001) There have
Potter, P.A., Perry, A.G., Stocker, P.A., & Hall. (2017). Fundamentals of Nursing (9th ed.). St. Louis, MO:
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]
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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
St. Louis, MO: Elsevier Ackley, B.J., Ladwig, G.B., & Flynn Makic, M. (2017). Nursing diagnosis handbook (11th ed.). St. Louis, MO: Elsevier University.
Potter, P. A., & Perry, A. G. (2009). Fundamentals of nursing (Seventh ed.). St. Louis, Mo.: Mosby Elsevier.