Excesive Restraints For Autistic Patient

By Walter F. Roche Jr.

One of the facilties in a six hospital system has been cited for keeping an autistic patient in restraints for some 32 days between late last year and early this year.
In a 22-page report made public last week, state Health Department investigators concluded the Penn Highlands Hospital at Huntingdon failed to limit admissions to its behavioral unit to patients it was capable of providing needed care.
The patient had a history of autism spectrum, intellectual disability and bipolar disorder, according to the report.
A review of records at the 71-bed facility showed the unnamed patient was kept in restraints for 32 days after displaying violent, self destructive behavior.
The facility "failed to ensure needed communication assistance was provided" to the patient who spoke little and gave one word answers.
Though the patient had in the past made some progress with visual icons, there was no record that they were utilized in dealing with the patient.
The facility failed "to ensure a patient received dignified care at all times," according to the report.
The report states that there was no documentation that the patient was re-assessed face-to-face every eight hours while in restraints.
"When a hospital provides psychiatric services, it shall be provided in a manner sufficient to meet the patient's needs," the report states, adding that a facility should limit admissions to those it is capable of providing needed care for.
Toileting problems with the unnamed patient were reported and in one instance the patient got off the toilet and charged at the staff.
"There was no documentation the patient had been offered toileting. There was no documentation of incontinence," the report states.
"We do not have the staff," one hospital employee told the state surveyors, adding that "Multiple people are needed for the care of this patient and one person can't handle this patient."
The facility also failed to develop an individualized treatment plan for the patient and failed to ensure that physician consults for possible surgery were implemented. In a plan of correction filed with the state the hospital said it would re-educate staff on the use of restraints, admission requirements and the rights and responsibilities of patients. Hospital officials did not respond to a series of questions about the report.
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