TIPS
FOR
OMBUDSMAN PRACTICE
If there is evidence of a problem with the use of physical or chemical restraints, consider the following actions. Be sure to follow ombudsman policies regarding complaint handling and encourage the complainant to engage in self-advocacy. Determine how the decision to use the restraint was made.
Was the decision an informed decision made by the resident or by the individual with the legal authority to authorize medical treatment for the resident? Does the resident understand the potential detrimental effects of the restraint? Were other options presented? Does the facility know what the resident wants or needs? Is the restraint being used to treat a symptom instead of the root cause of the symptom? Consider using the following resources in your review and preparation for resolution in
addition to federal and state laws and regulations: The Guidance to Surveyors regarding restraints and pertinent care issues. Resident Assessment Protocols (RAPs) of the Resident Assessment Instrument on physical restraints, psychotropic drug use, and others that might be relevant. The chart in Appendix C, “Context For Freedom From Physical Or Chemical Restraints Used For Discipline or Convenience.” “Good Care is Restraint Free,” Nursing Homes: Getting Good Care There. Burger, SG. Fraser, V. Hunt, S. and Frank, B. Impact Publisher, 1996, revised 1999. Also available from the National Citizens’ Coalition for Nursing Home Reform, 1828 L Street, NW, Suite 801, Washington, DC 20036. (202)-3322275; www.nursinghomeaction.org Ask for a care plan review to:
Determine the reason the restraint is being used. Determine what alternatives have been tried Consider other approaches to meeting the resident's need.