Nurses disciplined for using restraints on vulnerable patient with dementia

by | Oct 5, 2016 | Aged Care Blog, Health Blog

The use of restraints in dementia care was put under the microscope in the Health Practitioners Tribunal of South Australia, with two nurses being found to have engaged in professional misconduct for the unreasonable physical restraint of a vulnerable elderly patient.

The patient was initially restrained for some two hours in the Ward’s lounge room. Thereafter while he was still being restrained in a chair by means of a pelvic posey, the two nurses used a second pelvic posey to fasten the chair to railing in a corridor near the nurses station. The patient was left there for about nine hours. Contrary to general principles, common sense and various applicable codes he was not at any time released; he was in various states of undress; he was not toileted or given the opportunity to move around and no effective attempt was made to assess him.

The day after the incident the two nurses were suspended with pay, and a few years later, they were dismissed from their employment following the complaint by the Board.

The Tribunal found that the conduct complained of breached various codes of conduct and restraint policies. The Tribunal stated [at 13]:

“Just on general principles, a patient should not be left restrained in this way for that length of time without any effective effort to relieve him, give him comfort or allow him to move around and releasing him from that position.”

Further, the Tribunal said [at 18]:

“Restraint should only be used as a last resort after the involvement and consultation with senior staff. The patient should be released from time-to-time with continuous recorded assessment. … Their conduct was in breach of [the code of conduct for nurses] because they did not:

(a)    Practice in a safe and competent manner;

(b)    Respect the dignity, culture, ethnicity values and beliefs of people receiving care and of their colleagues;

(c)     Support the health, wellbeing and informed decision making of people requiring or receiving care;

(d)    Practice reflectively and ethically.”

The Tribunal concluded that the conduct was professional misconduct. Both nurses were reprimanded and suspended for a period of 9 months.

To read the decision in Nursing & Midwifery Board of Australia v Kiroff & Nyhan [2016] SAHPT 9, click here.

Emma Jack

Emma Jack