Reducing Use of Restraint & Seclusion Essay
Seclusion and restraint are applied to the health care setting to take care of patients, who have mental health problems. However, these methods are rather harmful than helpful, although these methods used to be widely-applied in the past. The restraint causes the patient to cause self harm because it is unbearable for them to be restrained. As a result, the injuries they suffer increase the costs of their treatment. The new intervention that is used to replace seclusion and restraint methods is friendlier to patients as well as to physicians, who work with patients. The intervention leads to a limited time of restraining the patient especially, if they are admitted before the treatment begins. Unlike the seclusion and the restraint that may lead to the death of the patient, the new intervention helps patients to stay safe and to reduce the death rate of the patient during the treatment period (Chandler, 2012). The intervention uses more skills since there is research carried about the patient before treatment is done.Reducing Use of Restraint & Seclusion Essay
Introduction
Seclusion and restraining are methods used to hold and confine mentally ill individuals to prevent them from causing physical harm to their bodies as well as other people around them. The research reveals the fact that, to some extent, seclusion and restraining of mentally ill patients may trigger the death of patients or their severe physical injuries. Most of the people, who are restrained because of the mental illness, suffer a physical injury during the seclusion period or restraining period. There are three main ways to apply restraining to the patient: the mechanical method, the physical method and the medical methods of restraining. According to the United States Health Department statistics, the death rate of the mentally ill patients, who are restrained, is about one hundred patients every year. The treatment of patients, who have the mental illness normally takes longer time, especially those that are undergoing seclusion method, when are taken to the nursing home, where they undergo their treatment.
Problem statement
The growth of death toll experienced in nursing hospitals, where the mentally ill patients are restrained, has resulted in a big loss to society and the country at large. Similarly, seclusion and restraining applied to patients with mental illnesses resulted in physical injuries and, in some instances, injuries were very severe and caused permanent disability of patients and caused the deformation or lameness to the patients. On the other hand, injuries increased costs of treatment of patients. Therefore, the literature review of this paper will look into the best ways of dealing with nursing care and treatment of mentally ill patients to minimize the risk of injuries of patients and to reduce death rates among them.Reducing Use of Restraint & Seclusion Essay
Research questions
The questions addressed are as follows:
First, how to come up with the appropriate method to handle mentally ill patients, when they are in nursing homes or when they are undergoing medication.
Second, how to ensure that the death rate and injuries caused during restraining of patients can be reduced especially in the prison setting.
Review of Literature
Problem
The use of restraint and seclusion in the nursing home setting, where patients, who have mental illness, receive their medication, imposes too much danger on the patient and raises many health issues. As a rule, the use of restraint interferes with tissues of the skin, where they are applied to the body. In most cases, restraint deters the flow of blood into some parts of the body thereby resulting in their fatigue. The use of seclusion and restraint, when patients are undergoing treatment, results in the loneliness and stress of patients especially, when patients are placed away from others. Stress and loneliness may trigger the development of other diseases in patients, such as high blood pressure and heart diseases. Similarly, seclusion may increase the time taken by the patient in the hospital to recover from the mental illness, while other diseases may emerge and complicate the condition of the patient and his/her treatment.Reducing Use of Restraint & Seclusion Essay
Loneliness makes the patient feel that he/she is not loved by his/her family that may urge the patient to commit suicide. When the patient is restrained for a long time, he/she becomes wild, when he/she is set free. Hence, the patient may cause injuries to other patients or health care staff in the nursing home, where he/she undergoes treatment. The use of drugs to restrain the patient may lead to overuse of the given drug thereby making the patient’s immune system resistant to the drug. Hence no change is experienced, even if the patient is given medication during seclusion and restraint periods. During mechanical restraint, the patient may undergo severe and harsh treatment that may affect and damage some of his reproductive organs in case the patient is male. The treatment of the patient, who is secluded or restrained, lasts longer and, therefore, the patient needs more time to recover from the mental ailment. Moreover, physicians fear the hostility of the patient and the danger they are likely to encounter, while prescribing the medication to the patients (Lewis, Taylor, & Parks, 2009).
Comparison
Intervention methods based on restraining and seclusion are accepted to some extent by some researchers and rejected by others. Alternative interventions may be used in place of seclusion and restraint, although the new intervention may be similar to seclusion and restraint in a way.Reducing Use of Restraint & Seclusion Essay
Similarities
Both general methods of treatment of patients and restraining and secluding of patients who are mentally ill, aim at keeping the patient safe along with the social environment of the patient (Chandler, 2012). Seclusion also prevents the destruction of properties by mentally ill patients as well as do general treatment methods, where restraint is not applied to the patient in the health care setting. Both the general treatment and seclusion require the use of drugs to keep the patient calm. In one way or the other, the two methods require fitting of the restraint tools to ensure that the physician is safe, when administering the drugs or when carrying out the injection to the patients (Chandler, 2012). Similarly, the two instances require the use of several people to hold the patient, when administering the medication for the first time. Chemical restraint is almost similar to the medical control intervention, since both of them require dosage, but in the medical control intervention, an appropriate dose is required, while in case of chemical restraint the dosage does not matter, whether it is an overdose or under dose.
Differences
General methods of treatment do not include the use of tools to restrain the patient, but, instead, they use drugs in the form of injections and pills, while seclusion and restraint involve the use of tools to prevent the patient from moving and causing damages. In the general treatment, the patient takes most of his/her time with his/her family members. Hence, such treatment makes the patient feel relieved, while in seclusion and restraint, the patient is left lonely in a place away from people. Hence, such treatment makes the patient feel stressed and even makes the patient develop new health problems, such as heart diseases (Lewis, Taylor, & Parks, 2009). Similarly, the patient has high chances of committing suicide because of loneliness, while, in the general treatment, the patient stays together with other people. Hence he/she feels secure and valued.Reducing Use of Restraint & Seclusion Essay
Patients, who undergo restraining and seclusion, suffer some injuries on the restraint part of the body, while those, who undergo the general treatment without restraint, are ever safer from possible external injuries since they are under the supervision of health care professionals or family members. In case the patient has the aim of causing injury to other people or him-/herself, they are restraint in the general treatment method for a very short period, while in seclusion and restraint, the patient is restrained for a long time. When the patient undergoes the general treatment, his/her privacy and confidentiality are protected and it is only family members, who may be informed about the health problem of the patient. In the secluded form of treatment, the privacy, as well as the confidentiality of the patient, is disclosed easily. In general treatment methods, doctors are well-trained handle the patient with mental illnesses without restraining them, whereas the seclusion method and restrained method do not require special ways of handling the patient since the handling of the patient involves the use of restraining tools that reduce the hostility of the patient (Blair, Woolley, & Szarek, 2017).
Since the new intervention makes use of the new technology to carry out the treatment of these mentally ill patients, it is easier to conduct the treatment as compared to the use of the manual method that requires much energy to fit the restraint tool on the hands and the feet of the patient. During the fitting of the restraint tool or when conducting the seclusion process, however, there is the likelihood of injuries of people, who carry out the process. The close monitoring of the patient by nurses clearly indicate the progress that the patient makes and the physician can easily know the type of drug to apply in case the previous ones did not work as expected, whereas in seclusion and restraint methods, the physician is very cautious to carry out the observation on the progress of the patient.
Interventions
Some of control interventions used in some health care organizations include the mechanical restraint, physical restraint, acute control medication and the use of seclusion. The acute control medication involves the use of medication as soon as the patient arrives in the hospital or the nursing home, where he/she intends to receive medication (Ashcraft, & Almvik, 2011). The treatment is done as fast as possible to make sure that destruction that is caused by the patient is controlled as well as the hostility is done away with, to ensure that no harm is caused to the physicians and any other individual around. Similarly, the treatment also aims at the prevention of self-harm that the patient may cause to himself/herself. Secondly, the mechanical restraint is applied to the patient, when the patient gets to the hospital, where he/she is ambulated in the bed to restrict the movement of the patient for the first time within the short period, when he/she receives his/her first medication (Loan, Gage, & Cullen, 2015).Reducing Use of Restraint & Seclusion Essay
The patient may also be ambulated on the feet or the hands to prevent causing injury, when brought to areas in the health care organization, where other people are located and to prevent the use of harmful material that can lead to destruction or death, when the patient is brought to the hospital for the first time and has not undergone treatment. Before the application of mechanical restraint, the patient is given a physical restraint to hold him/her for a little while, to calm the patient down. Later, after the calmness has been restored, mechanical restrained is applied to the patient to provide him/her with the acute control medication (Ashcraft, & Almvik, 2011). When the patient with mental illness arrives in the hospital, he/she is secluded into a room, where the patient cannot exit by any means. The three categories include the primary, secondary as well as the tertiary preventions. The primary intervention deals with precautions taken to ensure that the patient does not cause harm to any individual (Lewis, Taylor, & Parks, 2009). The primary precautions involve gathering of the information before the admission to the hospital.
Gathering the information also helps to understand the history of the patient. Whenever appropriate, control is conducted to the patient. During the primary prevention, the physicians makes a plan to handle the patient in terms of the rate of visiting as well as the physician takes decision on the further treatment of the patient (Loan, Gage, & Cullen, 2015). The primary intervention will be used to keep the patient in control and planning on when to start the treatment session of the patient. To some extent, the patients are asked questions regarding their safety and to understand the main cause of agitation in patients that makes them behave as they do. The main factors to consider in the primary prevention are the review of the history of the patient, the interview of the patient or family members concerning the health of the patient and finally the involvement of the nursing team into work with and handling the patient The intervention aims at the safety of the patient as well as the safety of his/her social environment (Lewis, Taylor, & Parks, 2009). The secondary prevention looks into the target symptoms of the patients. The feedback should also include suggestions that can be used alternatively to help the patient better. Patients are also provided with the comfort cart, if the need arises along with other intervention methods (Blair, Woolley, & Szarek, 2017).
In the tertiary prevention, the termination of seclusion and restraint is carried out. Various pieces of information are being collected to improve the treatment of patients (Lewis, Taylor, & Parks, 2009). At this stage, nurses also undergo training to improve their understanding of how to handle patients successfully without causing harm to them by seclusion or restraint (Blair, Woolley, & Szarek, 2017). Nurses also come up with a treatment plan that does not have misleading ideas and also contains different ideas of the treatment of patients with different types of character.Reducing Use of Restraint & Seclusion Essay
Conclusion
Thus, seclusion and restraint have been a great threat to lives and health of patients with mental illnesses. Therefore, an alternative method has to be introduced to subsidize the injury levels and death rates that result from seclusion and restraint. Several studies show that seclusion also gives rise to other dangerous health problems, such as heart diseases and high blood pressure, because of stress the patients suffers, while they undergo the treatment in the nursing home or hospitals. The use of intervention, however, helps in the improvement in the treatment given to the mentally ill patients and it also enhances the reduction in the recovery period of the patients. Due to the better handling of the patients in the hospital makes the patients suffer little injuries during treatment which would have been serious wounds in case the was secluded or restrained. When the new intervention is applied, instead of the seclusion or restraint, the destruction rate caused by the patient will be reduced, and the patient will equally enjoy the peaceful stay in the nursing home. The use of the new intervention enhances the provision of quality medication since the nurse, and other physicians undergo training to advance their experience in the treatment activity. The treatment given to the patients depends on the research conducted by the physician on the possible courses of the mental illness, and, therefore, it makes it easier to do the treatment of the disease.Reducing Use of Restraint & Seclusion Essay