Improper Use of Physical Restraint in Wheelchair
Penalty
Summary
A deficiency occurred when a resident with dementia, agitation, anxiety, and psychotic disorder was physically restrained in a wheelchair using a gait belt. The resident, who required substantial to maximal assistance for mobility and was at risk for wandering or elopement, was found with a gait belt wrapped around the arms of the wheelchair to prevent standing or falling. This action was taken by a CNA after the resident was observed to be restless, hallucinating, combative, and attempting to stand or walk during the night shift. The restraint was not authorized by a physician and was not part of the resident's care plan. The facility's policy states that residents have the right to be free from physical restraints unless authorized by a physician, used in an emergency, or requested by the resident or their representative with informed consent. The CNA involved stated that the intent was to keep the resident safe and was unaware that this constituted improper restraint. The use of the gait belt in this manner restricted the resident's freedom of movement and was not in accordance with facility policy or regulatory requirements.