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Care Center cited for use of five-point restraint

"The state Department of Social and Health Services cited the Port Orchard Care Center earlier this month for a high severity infraction after a nurse placed a 46-year-old patient into a prohibited, five-point restraint harness.Department of Social and Health Services staff were notified by care center personnel that the nurse placed the man into the restraint harness - which binds a patient's wrists, ankles and chest - for behavior problems demonstrated after he was checked into the facility Jan. 5.Bruce Dougherty, executive director of the Port Orchard Care Center, could not comment on the nature of the problems for patient confidentiality reasons.He said the center itself has a policy prohibiting restraints except in emergency situations, but the nurse made a decision to use the harness anyway based on the behavior of the patient and in consideration of his family's wishes.The facility does have a restraint-free policy. The individual chose to violate facility policy and did so at the request of the family. They felt it was in the interest of the individual, Dougherty said. We regret that this occurred, even though it was done with the best of intentions.As part of its citation, the care center drafted a correction plan - which was accepted by DSHS - and the nurse, who had turned in a resignation notice prior to the incident, is no longer working at the center.Staff members at the care center were retrained to ensure this doesn't happen again, Dougherty said.State and federal guidelines dictate when and how restraints may be used in a nursing home; DSHS prohibits their use for discipline or convenience. In addition, State and federal laws require a medical need for any kind of restraint, said Elaine Odum, regional administrator for residential care services for DSHS. Some regulations also require a time limit for use of a restraint - another issue noted in the DSHS investigation.During the investigation, DSHS staff learned the man had been in the restraint from about 10:45 p.m. until about 10 a.m. the next day. Although the Port Orchard Care Center's protocol requires restrained patients to be checked on every 30 minutes, Odum said, the man apparently was checked on at intervals ranging from 30 minutes to four hours and 45 minutes.Dougherty declined to comment on the alleged time lapse while the man was in the restraints. We did our investigative piece, he said.Odum said DSHS staff have not yet determined if the center will be fined or by how much. They did decide, however, there would not be a stop placement order imposed on the center. While the center responded immediately to the citation with a plan for correction and the nurse no longer works there, Odum said DSHS personnel and Port Orchard Care Center administrators were concerned about the incident. Administrators were very upset that nurses used the restraint, Odum said. Our concern was that it occurred and that there were three shifts of nurses who went through and nobody removed the restraints. "

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