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Ethics Of Chemical And Physical Restraints

1365 words - 6 pages

Ethics of Chemical and Physical Restraints

Ethics of Chemical and Physical Restraints
A restraint is the use of some kind of equipment or drug used for the purpose of restricting a patient from free will movements. There are times when using restraints would seem like the best thing to do for a patient, but in-fact it could be quite the opposite. Agens Jr., J. (2010).
The use of restraints is mostly used to deal with an agitated patient, mainly can be found in residential-care facilities. Those 65 years and older have been reported to have higher restraint use rate in residential and acute care facilities. Many have been found with at least two different types of restraints at the same ...view middle of the document...

The elderly that suffer from delirium or dementia that may be a danger to themselves or others and the staff no longer has the ability to protect or take care of the patient. Then some sort of restraint may need to be used but not before it was clearly documented with the situation, followed by an assessment of the patients behavior, and a physician’s order. This must be done right before or right after the institution of any restraints. No restraints should be used without failure of all other alternatives.
These patients with the dementia and delirium may be given an antipsychotic drug to restrain them but this does not have FDA approval. In a meta-analysis, Agens Jr., J. (2010) it has been shown that an increase in death of 1.6 to 1.7% with the elderly patients. Different researches have also suggested that any antipsychotic medications can cause death just as easy. With this known risk it is very clear that if this medication is used that should not only be prescribed by the physician but also be documented for the informed consent process.
The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) brought the results that say patients have every right to be free without the use of restraints and are not to be used for convenience or for discipline purposes. It also states that a patient being uncooperative, restless, wandering or being unsociable does not justify in the use of any kind of restraint.
In the case of delirium or dementia that opposed any danger to others or to themselves and the staffs ability to protect or take of the patient. In that case some sort of restraint may need to be used but not before it was clearly documented with the situation followed by an assessment of the patients behavior, and physician’s orders. This must be done right before or right after the institution of any restraints. No restraints should be used without failure of all other alternatives first. Agens Jr., J. (2010)
There are ways to reduce restraint use before it is needed and when they are being used. Agens Jr., J. (2010). For example better pain management, bowel, and bladder functions, sleep habits, reducing noise, and lights. These all can play a big part in the reduction of needing to restrain someone.
If those attempts have failed and it seems like restraints are still needed, the patient should be further examined for some kind of illness like and infection, respiratory, or heart. Any of these should be checked out when a patient is experiencing safety changes like falling or acting in an unusual way.
To assess a patient before deciding on the need for restraints will need to involve the opinion of physical therapist, occupational therapist, social worker, nursing staff, pharmacy, and the family. If after consulting with everyone, and they come across the cause of the...

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