The purpose of the Griffin Hospital study was to compare the current restraint system with the Soma® Safe Enclosure for agitated hospitalized patients. Aspects studied included the safety, length of stay, health care professional’s satisfaction, acceptability, ease of use, and comfort of the two types of restraint systems used in hospitalized patients.
Archive for Clinical Research
Mr. R. was a 68 year old gentleman admitted to the Long Term Care (LTC) Facility from his home with a diagnosis of worsening Huntington’s Chorea. The patient had been in the care of his family. To help control the patient’s involuntary writhing and spastic movements, chest and limb restraints had been used on a near continuous basis. The patient also had several pressure ulcers.
The Director of Nursing was very concerned about the most effective approach to this difficult patient / family situation. Following the Joint Commission of Accreditation of Healthcare Organization (JCAHO) Standards (1) as well as the Health Care Finance Administration (HFCA) regulations (2) for the “least restrictive device”, many issues were explored. Top consideration was given to choosing the most effective device that would provide comfort, dignity and safety for the patient as well as peace of mind for the family. It was also important that the nursing staff have easy access to provide patient care.
Mr. L. was a 33-year-old male who had suffered a traumatic closed head injury resulting in temporal lobe fracture, cervical injury and non-displaced fractures of several thoracic vertebrae. Lower extremity paralysis, prolonged coma, seizure disorder and ventilator dependency resulted from the initial trauma.
As the recovery process began, Mr. L remained in a semi-stuperous state and suffered from frequent episodes of intense agitation. During these episodes, the patient thrashed about the bed throwing his head and extremities against the bed rails with such force that numerous bruises and lacerations developed. More than once, he threw himself to the floor.
The nursing staff attempted to restrain the patient using chest and wrist restraints, which only increased his irritability and thrashing behavior. Next, the restraints were removed and the bed rails were padded, but again the patient threw himself to the floor. The bed was kept in the lowest position at all times, but this made it difficult for the staff to carry out any procedures and several were treated for back pain after attending to Mr. L's needs.