PA Hospitals Cited on Restraints

By Walter F. Roche Jr.

Two Pennsylvania hospitals located at opposite ends of the state have been cited by state Health Department surveyors for misuse of restraints, a recurring problem at health facilities.
UPMC Altoona and Nazareth Hospital in Philadelphia's Northeast were cited in reports recently made public.
In Altoona state inspectors found that a patient had been placed in a locked seclusion room without any medical or safety justification.
Citing the facility's own policies barring the use of restraints or seclusion for the convenience of hospital personnel, the surveyors determined the patient, who posed no threat to self or others, was kept in the locked room for an undetermined length of time.
When one employee of the facility was questioned she said that she was making a periodic check of the emergency area in February, "I noticed that someone was in the seclusion room. The door was locked and I walked in.Once we investigated," the employee contiued, "It was determined this patient should have never been placed in locked confinement."
The employee told the state inspector there was no medical justification for placing the patient in a locked room.
In addition although the seclusion room was supposed to be under 24 hour camera surveillance there was no tape of the session in question.
The surveyor also noted that the surveillance monitors could be viewed by patients or visitors, thus violating privacy rights.
The survey also noted there was no call bell in the seclusion room.
In a plan of correction filed by the hospital, officials promised to implement a re-education and monitoring program to ensure hospital policy was being followed.
At Nazareth Hospital an April visit by state health surveyors showed 10 patients had been placed in restraints without a required physician's authorization. In a related deficiency, the state inspectors found that the hospital failed to perform the required periodic reviews of the need for restraints to be continued.
Nazareth was also cited for leaving patients in hallways in the emergency area for excessive periods. The limit, according to the report is six hours but one patient was kept in a hallway for some 10 hours.
The hospital filed a plan of correction in which it promised to file the required infrastructure reports, re-educate staff and conduct daily reviews on restraint use.
The report also cited the hospital for failure to report an infrastructure failure - the lack of available beds- to the state.
Neither hospital replied to questions or a request for comment.
The two facilities are hardly the first in Pennsylvania to be cited for over-use or misuse of restraints. Among other facilities cited for the same deficiency is the Washington Hospital in Washington County.
That facility was cited for placing three patient in handcuffs without a physician's order.
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