I am getting several different points of view on the use of and need for
informed consents with the use of a physical restraint that was assessed to
be medically necessary to treat a medical symptom by the interdisciplinary
team. We have mock surveys at our sister facilities in the area. One of the
administrators said that families cannot dictate use of a restraint and we
do not need their permission to restraint if it is properly used to treat a
medical symptom. The other administrator says the informed consent is still
needed. Our consultant said that we are getting mixed up in the terminology.
She said that the families / Responsible parties have to be notified of the
use of the restraint, medical reason, risks of uses, risks of non uses, but
they do not have to "give us permission". My understanding of the F tag and
guidance to the surveyors is that the responsible party cannot tell us to
restrain a person without just cause (i.e. discipline, convenience or no
medical symptom) but the guide is not clear about the right to refuse the
treatment. If they refuse the restraint and we have tried everything else,
then what do we do? Tell the family that we cannot provide the care their
loved one requires... How often do you review restraint use with MD and
family? Right now we review quarterly for reduction but MD and family are
only notified when it is initiated and when a reduction is planned. Sorry
for being so wordy!!!!!
Thanks in advance to whoever was brave and read this!!
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