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Chemical restraints on nursing home patients

The use of chemical restraints on nursing home patients is a growing concern in today's society. Because of the widespread and ease of availability of prescription medications, it is not difficult for nursing home staff to get their hands-on sedatives. If a patient is particularly difficult, staff members may not hesitate to use those sedatives to make their jobs easier. Doing so is both illegal and dangerous.

According to American Nurse Today, a peer-reviewed and official journal of the American Nurse Association, a chemical restraint is one that involves the use of a drug to restrict a patient's behavior or movement. The drug or dosage is one that a patient's medical provider did not approve for his or her condition and/or that is not standard for his or her condition.

Though the ANA encourages nursing home staff to use alternatives to restraints, it does acknowledge that there is a time and a place for them. For instance, if a patient has several tubes, drains or lines inserted into him or her, and if that patient has a known history of dementia, confusion, restlessness or agitation, staff might opt to use physical or chemical restraints to keep the patient from pulling the lines out. It would do so to enhance patient care.  

Nursing homes may also permit their staff to use restraints for violent or destructive patients. Violent patients often pose a health risk to themselves and others and sometimes, the only way to calm those patients down is via the use of chemical restraints. This is particularly true in patients that experience hallucinations. 

Because more nursing homes have begun to abuse chemical restraints, regulatory agencies have begun to devise guidelines for using them. Per the Legal Information Institute, if chemical restraints are necessary to ensure the physical safety of a patient or others, use must meet certain conditions.                                                                    

For one, providers may only use restraints for a limited period of time and based on the needs of the patient. Two, staff must administer medications in accordance with safe and appropriate techniques. Three, staff may only use chemical restraints when it has exhausted other, less restrictive measures. Finally, staff must remove restraints as soon as possible. The LII mandates that nursing home staff monitor restrained patients on a continual basis.




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