tag:blogger.com,1999:blog-7840162053217200275.post8639282617336233797..comments2023-05-07T04:45:09.407-07:00Comments on DNR/DNI: A Restraint Free Nursing HomeLeo Levyhttp://www.blogger.com/profile/01158923108724721854noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7840162053217200275.post-31785961488938117612009-01-18T07:39:00.000-08:002009-01-18T07:39:00.000-08:00Conciergedoc has written words I have been hankeri...Conciergedoc has written words I have been hankering for. Are the consequences of pulling a feeding tube etc. worse than the consequences of restraining the patient? I think the answer is often 'no,' but for the sake of appearances we are often forced to do what we do not want to.Leo Levyhttps://www.blogger.com/profile/01158923108724721854noreply@blogger.comtag:blogger.com,1999:blog-7840162053217200275.post-73264448056281258932009-01-17T23:22:00.000-08:002009-01-17T23:22:00.000-08:00I am amazed to discover that this is still happeni...I am amazed to discover that this is still happening. When I finished my Geriatrics Fellowship just 3 years ago, Boston University Med Ctr became a 100% restraint free institution (except ICU). Velcro regardless of how used is a restraint. Anything that prohibits a patient from following out on his/her impulses is a restraint - to his harm or not. and to my understanding, BUMC honors this restraint free policy to this very day. And from a practical standpoint, this is a 626 bed institution. I am now the medical director of a medium size nursing home. We have NEVER used a restraint of any kind. <BR/><BR/>This policy works for our dementia filled nursing home, and a 626 bed hospital. So why it does not work anyone else is more a issue of complacency. A demented patient who pulls his tube - let him. If he does it often enough, families usually accept that the tube is a bad idea and they stop it. IVs - please, cover with lots of cloth and tape it. There is never a reason for restraint. the obly exceptions being outside of ICU where they are recieving acute lifesaving interventions or violence that cannot be controlled by other means.<BR/><BR/>The hardest thing I've had to do is teach my current institution to institute a similar 100% restraint free policy.Conciergedochttps://www.blogger.com/profile/15132330035246908886noreply@blogger.com