Importance Of Physical Restraints

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Improving the Proper Initiation and Use of Physical Restraints in 4 East
A Microsystem Plan Essay
Background
The St. Joseph Medical Center 4 East Department consists of 30 beds, specializing in patients with respiratory issues. The patients are adults, mostly geriatric with comorbid conditions such as Congestive Heart Failure (CHF), sleep apnea, Diabetes Mellitus (DM), and many more. The patients come from home, Skilled Nursing Facility (SNF), assisted living, board and care, and a locked down unit. The patients are monitored and oftentimes need nebulizer breathing treatments, postural drainage and percussion (PDP), and/or Bipap. Due to their respiratory condition, most of the patients are on oxygen to assist with their breathing. There are patients that are unable to ambulate due
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In the respiratory unit, physical restraints are used when patients are combative, threat to self, and pulling out contraptions needed for the therapy, such as Bipap and Vapotherm. Physical restraints are a patient safety concern. “Evidence shows that… restraints don’t necessarily prevent patient harm, and in some cases, they contribute to increased delirium or other serious injuries” related to restraints (HCPro, 2015, p. 8). The knowledge and skills in the proper initiation, application, assessment, and termination of a physical restraint are vital in the prevention of sentinel events. The Center for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC), both established a precise standard for appropriate use of restraints to “help hospitals that experience serious adverse events, improve safety… as well as evaluation of corrective actions, is essential to reduce risk and prevent patient harm” (TJC, 2016). Although it varies from state to state or facilities, improving the proper use of physical restraints will ensure safety and compliance leading to an excellent provision of

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