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Although the use of restraints can be beneficial in preventing falls, they can also be
an area of risk for patient safety if used inappropriately. Because of this, we have
developed extensive policies and procedures that guide the use of restraints. The
procedures ensure the following:
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Restraints are used only when they are indicated by the patient’s condition and
ordered by the physician.
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Each episode of restraint use is reviewed and monitored by the staff with the goal of
discontinuing them as soon as possible or using alternatives to keep the patient
safe.
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Staff is trained and must demonstrate their ability to safely apply and remove
restraints.
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While patients are in restraints, they are monitored every 15 minutes to be sure they
are safe and their needs are met.
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Whenever possible, patients and their families are involved in the decision whether or not
to use restraints.
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For the past two years, Little Company of Mary has placed a major focus on safe and effective
pain management for our patients through our Pain Management Initiative. We have been in the
forefront among hospitals in these activities. Practices we have implemented to increase the
safety of pain management are as follows:
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Development of policies and procedures related to Patient Controlled Analgesia (PCA) and
Epidurals to ensure standardization and the same level of care throughout the
organization.
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Training of nurses in proper use of pain medication administration devices and
equipment.
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Ongoing evaluation of the nurses’ competency in use of equipment and following
of procedures.
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Multiple double checks by a second RN staff member ensure safe delivery of pain
medications.
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Pressure sores are an area of focus for the Patient Safety Program. The following preventative
measures are used to help prevent the development of pressure sores and the worsening of
existing sores:
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Protocols are used on admission and on an ongoing basis to assess the patient’s skin
condition and determine the level of risk.
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Frequent turning and skin care protocols are followed.
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Special beds and mattresses to prevent skin breakdown are utilized when
indicated.
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We have implemented strategies to help prevent
wrong-site surgeries and procedures. These include:
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When indicated, the correct operative sites are clearly marked.
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Patients are involved in identifying and marking the correct operative site.
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Procedure is initiated.
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Medications are reviewed and double checked by the surgeon and the anesthesiologist
prior to administration.
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