177 REDUCTION OF RESTRICTIVE PRACTICES IN AN OLDER PERSON RESIDENTIAL CARE FACILITY; THE IMPACT ON HUMAN RIGHTS AND RESIDENT SAFETY. (18th November 2021)

• Record Type: Journal Article
• Authors: Hogan, F H; Ahern, A; Faherty, L; Lordan, R; O'Toole, M
• Is Part Of: Age and ageing. Volume 50(2021)Supplement 3
• Publication Date: 2021-11-18
• Subjects: Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afab219.177
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: Background: We are a 140 bed long term care residential care facility for older people. We strive to achieve a 'Restraint Free Environment' in accordance with Article 40.4 of the Irish Constitution and Articles 14 (liberty and security) and 15 (freedom from torture or cruel, inhuman or degrading treatment) of the UN Convention on Rights of Persons with Disabilities (1) . Health Act 2007, Regulations 2013 defines restrictive practice as 'the intentional restriction of a person's voluntary movement or behaviour'. Use of restrictive practices is warranted when there is a real and substantial risk to a person and this risk cannot be addressed by non-restrictive means' (HIQA, 2019) (2) . Methods: An extensive review of non pharmacological restrictive practices in the Organisation was undertaken. This included One to One supervision, use of bedrails, Exit Alarm mats and Electronic Monitoring bracelets. Bedrails were replaced for some residents with Safety Wedges and Ultra Low beds. Results: Review of restraint interventions showed no clear link to prevention of falls or injuries as a result of restraint. Contrary there was evidence of breach of dignity and privacy for the residents. Based on the review, bedrail use was reduced radically between 2016 and 2021 by 79% (42–9). Falls rate remained consistent approximately 3.6–3.2 per 1, 000 Occupied Bed Days. Exit Alarm mats, Electronic Monitoring bracelets and One to One supervision was discontinued. These were replaced with direct observation and two hourly anticipation of needs. Cost saving on One to One estimated to have been €25, 000 in 2016 alone. Clear care planning of the resident's needs are core. Conclusion: We have demonstrated that we could successfully reduce restrictive practices, thus respecting Human Rights, with no compromise to resident safety. References: 1. United Nations Convention on Rights for Persons with Disabilities (2007) 2. H.I.Q.A 2019 Guidance on promoting a Care Environment that is Free of Restrictive Practice.