Physical Restraints: Court Refuses To Find Nurse At Fault For Discontinuing Patient's Posey Vest
Legal Eagle Eye Newsletter for the Nursing Profession
Quick Summary: There is an enormous sense of judgment that goes into the decision to use or not to use physical restraints on patients.
That judgment is based on the patient’s behavior, the cause of the patient’s discomfort, the patient’s medications, the patient’s need to be ambulatory, the physician’s orders and whether or not the patient has the ability and will have the opportunity for self-harm. COURT OF APPEALS OF WASHINGTON, 1997.
According to the Court of Appeals of Washington, a healthcare professional is not liable in civil court for an honest error in judgment, provided that in arriving at that judgment the healthcare professional exercised reasonable care and skill within the legal standard of care for the provider’s profession.
Specifically, the court ruled that a nurse’s decision to discontinue a patient’s "soft" physical restraints is not to be second-guessed by a jury, if the nurse had made a competent nursing assessment before taking such action, and the patient later happened to fall.
In this case the court ruled that the hospital was not at fault when a patient fell getting out of bed with a nurse’s assistance, just because a nurse earlier that day had removed his Posey vest.
The court looked at other cases going back over thirty years, where physicians had been sued for negligence for ordering restraints discontinued. A nurse as well as a physician can make an assessment that a particular patient is better off without restraints, the court concluded.
The decision to continue or discontinue physical restraints is a choice that must be made by the healthcare professional caring for the patient. It is an exercise of professional judgment, based on the patient’s best interests.
It is not correct, according to the court, that keeping patients under physical restraints is a simple matter of maintaining custodial security. Use of restraints, or not using them, is a matter of therapeutic concern for the patient’s needs. Gerard vs. Medical Center, 937 P. 2d 1104 (Wash. App., 1997).
More references from nursinglaw.com
http://www.nursinglaw.com/restraint.htm
http://www.nursinglaw.com/restraints2.htm
http://www.nursinglaw.com/restraints-nursing-negligence.pdf