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Labrador Grenfell Health use of restraints in long-term care higher than national average

The LGH Labrador Health Centre in Happy Valley-Goose Bay.
The LGH Labrador Health Centre in Happy Valley-Goose Bay. - Evan Careen

Vital signs report identifies potential inappropriate use of anti-psychotics also high across province

HAPPY VALLEY-GOOSE BAY, N.L.

According to the annual Vital Signs report, restraint use in long-term care within Labrador Grenfell Health (LGH) is much higher than the national average.

Nationwide usage of restraints in long-term care is at seven per cent, provincially it’s 14 per cent and in LGH is 19 per cent.

Donnie Sampson, vice-president and chief nursing officer for LGH, said they recognize it’s an area they need to improve, both in usage and educating staff and the public on what is meant by restraints.

She explained that restraints fall into three categories—chemical, physical and environmental.

As an example, if a client was at risk for falls, they could raise the side rails on the bed and in this documentation that could look like an environmental restraint. If a nurse put a table in front of a client who is sitting that’s considered a physical restraint.

“I think it’s educating some of our staff, really, about what restraints means and the categories and making sure our documentation is appropriately done,” she said. “Sometimes I don’t know if people understand a side rail can be considered a restraint and why you’re doing a side rail.

“So it’s more policies and clarity. We do have policies about physical restraint. We want to use the least restraint. No restraints is where we want to go.”

The Vital Signs report, put together yearly by Memorial University’s Harris Centre and the Community Foundation of Newfoundland and Labrador, looked at a variety of different metrics in the province, in a variety of categories.

Under the Health and Wellness section, one of those areas is long-term care.

The report broke it down to three categories—restraint use, potentially inappropriate use of anti-psychotics and improved physical functioning in long-term care.

In terms of potentially inappropriate use of anti-psychotics, the province is approximately 30 per cent higher than the national average.

Sampson said this is an area they (and the other health authorities in the province) have been working on with the Canadian Federation for Health Information (CFHI) to improve.

“Some reasons is that it’s for behaviour—people are more at risk for falls—we’ve done a lot of good work removing people from antipsychotics that really didn’t need to be on it,” Sampson said. “We’ve done a lot of good work and had a lot of successes come out of that.”

Being above the national average in terms of improved physical functioning in long-term care is a good thing, with the national average being 31 per cent and the province being at 40 per cent.

“It shows that when our residents come in they’re maintaining their independence as long as possible and are able to function,” Sampson said. “For those key indicators we’re starting to really monitor and measure them.

“We only really went online fully about a year or two ago, with the electronic reporting into CFHI. Now is a good time for us to see where we are and how we’re doing and hone in to make improvements where we needed.”

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