JCAHO restraint guidelines follow other groups’ leads
December 1, 1999 2 minutes read
JCAHO restraint guidelines follow other groups’ leads
Restraints have been a hot issue in health care recently, and the more recent guidelines follow on the heels of those issued by two leading professional organizations. Most of the guidelines suggest that the use of restraints and seclusions can be reduced significantly in some situations and that any use must be well-justified.
The most recent guidelines for restraints and seclusion in behavioral health come from the Joint Commission on Accreditation of Healthcare Org anizations in Oakbrook Terrace, IL, but the issue has been addressed recently by the American Hospital Association (AHA) and the National Association of Psychiatric Health Systems (NAPHS), both in Washington, DC. Both organizations serve on the Joint Commission’s board-level task force on restraint and seclusion, which recommended the measures in the new guidelines.
(Healthcare Risk Management has covered the issue of restraint use extensively. For details, see "Guidance issued on use of restraints, seclusion," April 1999, p. 49; "JCAHO: Zero tolerance on restraint deaths," July 1999, p. 86; and "New regs on restraint use follow JCAHO’s lead," September 1999, p. 111.)
These are the guiding principles established by the AHA and NAPHS:
• A patient’s overall treatment is based on a comprehensive, individualized treatment plan that includes appropriate patient and family involvement.
• Hospitals and other treatment settings serve individuals with severe mental illnesses and substance abuse problems who are, at times, dangerous to themselves or others.
• Restraint and seclusion should be used as infrequently as possible, and only when less-restrictive methods are considered and are not feasible.
• Restraint and seclusion are emergency interventions that aim to protect patients in danger of harming themselves or others and to enable patients to continue treatment successfully and effectively.
• Prevention of injury and death is essential.
• Hospitals and other treatment settings must ensure that staff are well-trained and continuously educated regarding the proper use of restraint and seclusion. Detailed policies, procedures, and systems must be developed with input from physicians and other mental health professionals, and they must be understood and followed by all staff.
Sources
o National Association of Psychiatric Health Systems, 1317 F St. N.W., Suite 301, Washington, DC 20004. Telephone: (202) 393-6700. Free copies of the guiding principles may be obtained from the NAPHS by calling (202) 393-6700, Ext. 15.
o American Hospital Association, 325 Seventh St. N.W., Washington, DC 20004. Telephone: (202) 626-4628.
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