Today I heard Diana Waugh RN speak on Restraint and Alarms Elimination. Diana's approach is mildly abrasive and humorous, screaming at DONs in the back of the hall getting up to go to the bathroom. I've seen this approach before, but just as an attention getter. She uses it to effectively illustrate how we treat our own residents in an effort to prevent falls, racing towards people and making them feel as though getting up after a meal to use the restroom is a punishable action.
Here's what I took away from her presentation, which I hope to elaborate on soon:
1. No level of pain is acceptable for our residents. Falling out of a low bed 18 inches to the ground still hurts, so why do we lower a bed and call it an intervention?
2. We ask to be surveyed. You don't have to accept payment from the government. We have equal access to the regulations and the guidelines just like the surveyors. I sat in a room of 200 professionals today and less than five percent could say that they had read the new guidelines published this year. This makes it hard to be refute a citation or use the guidelines to improve care delivery.
3. We are allowed treat our residents in ways that the CIA is no longer allowed to treat terrorists. If a prisoner is put in restraints, he has a person monitoring him 24 hours a day. Why? Restraints are dangerous. they kill people. We put demented residents with alarms that blare up to 80 decibels when they try to scratch their ankles, but sleep deprivation is now considered a war crime. Siderail deaths have been tracked by CMS since 1995 for a reason. Posey puts a warning on their restraint guidelines telling users that their devices are only for cognitively aware residents. When was the last time you restrained a resident per their request?
Thanks to Diana Waugh for an eye-opening day. I highly recommend that you see her speak if you have a chance and are willing to open up your mind to some pretty basic concepts that many of us ignore as healthcare professionals. Just don't get up to go to the bathroom.