LGH use of re­straints in long-term care higher than na­tional av­er­age

Vi­tal signs re­port iden­ti­fies po­ten­tial in­ap­pro­pri­ate use of anti-psy­chotics also high across prov­ince

The Aurora (Labrador City) - - Front Page - BY EVAN CA­REEN

Ac­cord­ing to the an­nual Vi­tal Signs re­port, re­straint use in long-term care within Labrador Gren­fell Health (LGH) is much higher than the na­tional av­er­age.

Na­tion­wide us­age of re­straints in long-term care is at seven per cent, provin­cially it’s 14 per cent and in LGH is 19 per cent.

Don­nie Samp­son, vice-pres­i­dent and chief nurs­ing of­fi­cer for LGH, said they rec­og­nize it’s an area they need to im­prove, both in us­age and ed­u­cat­ing staff and the pub­lic on what is meant by re­straints.

She ex­plained that re­straints fall into three cat­e­gories— chem­i­cal, phys­i­cal and en­vi­ron­men­tal.

As an ex­am­ple, if a client was at risk for falls, they could raise the side rails on the bed and in this doc­u­men­ta­tion that could look like an en­vi­ron­men­tal re­straint. If a nurse put a ta­ble in front of a client who is sit­ting that’s con­sid­ered a phys­i­cal re­straint.

“I think it’s ed­u­cat­ing some of our staff, re­ally, about what re­straints means and the cat­e­gories and mak­ing sure our doc­u­men­ta­tion is ap­pro­pri­ately done,” she said. “Some­times I don’t know if peo­ple un­der­stand a side rail can be con­sid­ered a re­straint and why you’re do­ing a side rail.

“So it’s more poli­cies and clar­ity. We do have poli­cies about phys­i­cal re­straint. We want to use the least re­straint. No re­straints is where we want to go.”

The Vi­tal Signs re­port, put to­gether yearly by Me­mo­rial Univer­sity’s Har­ris Cen­tre and the Com­mu­nity Foun­da­tion of New­found­land and Labrador, looked at a va­ri­ety of dif­fer­ent met­rics in the prov­ince, in a va­ri­ety of cat­e­gories.

Un­der the Health and Well­ness sec­tion, one of those ar­eas is long-term care.

The re­port broke it down to three cat­e­gories—re­straint use, po­ten­tially in­ap­pro­pri­ate use of anti-psy­chotics and im­proved phys­i­cal func­tion­ing in longterm care.

In terms of po­ten­tially in­ap­pro­pri­ate use of an­tipsy­chotics, the prov­ince is ap­prox­i­mately 30 per cent higher than the na­tional av­er­age.

Samp­son said this is an area they (and the other health au­thor­i­ties in the prov­ince) have been work­ing on with the Cana­dian Fed­er­a­tion for Health In­for­ma­tion (CFHI) to im­prove.

“Some rea­sons is that it’s for be­hav­iour—peo­ple are more at risk for falls—we’ve done a lot of good work re­mov­ing peo­ple from an­tipsy­chotics that re­ally didn’t need to be on it,” Samp­son said. “We’ve done a lot of good work and had a lot of suc­cesses come out of that.”

Be­ing above the na­tional av­er­age in terms of im­proved phys­i­cal func­tion­ing in longterm care is a good thing, with the na­tional av­er­age be­ing 31 per cent and the prov­ince be­ing at 40 per cent.

“It shows that when our res­i­dents come in they’re main­tain­ing their in­de­pen­dence as long as pos­si­ble and are able to func­tion,” Samp­son said. “For those key in­di­ca­tors we’re start­ing to re­ally mon­i­tor and mea­sure them.

“We only re­ally went on­line fully about a year or two ago, with the elec­tronic re­port­ing into CFHI. Now is a good time for us to see where we are and how we’re do­ing and hone in to make im­prove­ments where we needed.”

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