Patient restraints have been implicated in a number of hospital negligence cases. Restraints can be physical, like lashing a patient to their bed. There are also medical restraints, where a patient is medicated to the point where they cannot leave their bed. Restraints are used to control patients in hospitals and nursing homes who are suffering from psychiatric and neurologic disorders. The U.S. Centers for Medicare and Medicaid Services (CMS) is trying to reduce the use of restraints because of complications associated with both types of restraints and the fact that they do not comport with basic human rights. Hospitals and nursing homes, on the other hand, are increasingly using restraints as a way to get away with lower staffing ratios, with little regard for safety concerns or dignity.
A recent article published by MedPage Today reflects just how overused restraints are. The article reports one example where “[m]ore than 800 of every 1,000 hours psychiatric patients were hospitalized … were spent in some kind of physical restraint.” According to the author, “Industry experts say restraining patients is much more common than it should be and often is a sign of overworked and understaffed nurses.” One physician reported that “[c]hildren with behavior disorders are also being drugged into submission in outrageously high numbers.” CMS regs restrict use of restraints to situations where they are “medically necessary,” and the least restrictive restraint must be used.
Why is the overuse of restraints bad? Physical restraints have been implicated in strangulation deaths. In addition to asphyxia, they can lead to compromised blood circulation and amputation. Bedridden patients are at risk for a fatal pulmonary embolism (PE). There may also be a tendency for staff to perform fewer assessments on a restrained patient, especially when they are understaffed to begin with. Drugging patients to control them carries risks as well. Long-term use of antipsychotic medications can cause tremors or tardive dyskinesia. When discontinued, some of these drugs can cause psychotic episodes.
Under Ohio law, a hospital or nursing home negligence case may arise if restraints are used without a doctor’s order, used without adequate justification, or used with inadequate monitoring of the patient, and the misuse of the restraints results in injury or wrongful death.
As an Ohio medical lawyer who handles hospital negligence and nursing home neglect and abuse cases involving the misuse of restraints, the MedPage Today article points out a troubling trend. However, we can expect hospitals and nursing homes to continue to overuse restraints as a way to minimize labor costs and maximize profits.
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