Human health is a very important factor which should be given the first priority by any government that minds its people. This is because when people in a given nation are protected from diseases and receive proper treatment whenever they are sick, they will be in a good position to contribute to the development of the nation. It follows with very little doubt that a healthy population means a healthy nation (Britt, 2004, p. 31). However, as human beings grow old, their bodies become weak and they become susceptible to attacks by diseases. Due to this factor, aged people require more attention in terms of health care. This factor made the government of Australia to come up with health care facilities to take care of old people. In these aged care facilities, there is use of restraints which is not generally accepted by most people. This piece of work tries to analyze some of the issues and responsibilities which are relevant to health professionals regarding the use of restraints.
Aged care facilities in Australia use restraints to provide care for aged people. Restraints are usually physical means that are used by health experts to restrict movement of some parts of a body of a patient. This implies that a device is used to ensure that patients cannot sit in a certain position or move some of their body parts as they would like them to move. Restraints also mean that the patient is confined in a particular area and she/ he is not allowed to move beyond an area that is intended by the health care personnel. A third way in which a patient is restrained is the use of chemicals to make some body parts or the whole body of a patient to be less active (Fryback, 1998, p. 136). Restraints deny an individual the freedom of movement including other human rights such as the right to freely assemble and associate with others. It is therefore very important for health care professionals to employ the use restraints only when necessary (Department of Health and Ageing, 2009, web page). To do this, the health professionals must consider a number of issues and apply their work ethics so as not to infringe on the rights of old people under their care.
First of all, people who intend to be health professionals to provide health care to both the old people and other patients using restraints should undergo formal training concerning the use of restraints. This will enable them to use appropriate devices for restraints. It will also enable them to know situations in which restraints can be used otherwise if they are not well trained they can use restraints in situations where better alternatives are available. The training should include ways that the professionals can use to ensure that the restrained person is not exposed to other health risks that may arise as a result of restraints (Briggs, 2005, p. 79). Among very important factors that should be included in the training should be the appropriate methods of monitoring the health of a person who is restrained to assess whether the restraints have some positive effects on the restrained person or the effects are negative.
Secondly, it is very important to carry out an assessment of behavior of an individual to identify whether the use of restraints is necessary or not. This is because some patients may have some behaviors that might interfere with the rights of others and therefore they have to be confined to minimize their movement. For example, some people may become aggressive and might even attack others. Such cases are common in people with mental disorders and they can be easily handled when restraints are used on them. The fact that restraints are usually used for people with mental problems makes the old people who are in aged care facilities in Australia to view the use of restraints with negative perception.
In addition, physical condition of an individual can influence health professionals to use restraints on them. For example, when a patient has a broken limb, health professionals may be forced to use restraints on them to ensure that the broken limb stays in a certain position as treatment proceeds. Restraints are used in aged care facilities in Australia so as to keep the old people in certain desired posture. This is because some of them have grown old to the extent that they can no longer stay in their original posture.
The use of restraints in health care facilities should be considered as a temporary measure which is employed to change the behavior of an individual (Smith, 2004, p.26). It is on this basis that the administrators and managers of health care centers have responsibilities of ensuring that they provide environments that are free from restraints and that they should only be used when there is no any other better alternative. It is recommended that each and every health care facility should set out policies to ensure that their staff members strictly follow principles and regulations relating to the use of restraints. They also have responsibilities of ensuring that restraints that are used within their facilities do not interfere with the basic rights of individuals such as the basic right of free movement of an individual. Agencies that provide health care also have responsibilities of ensuring that their policies regarding the use of restraints are clearly stated and are easily accessible by people who are concerned and may want to see them.
Another important issue to be considered before the use of restraints on patients or any old person is the consent of the concerned people. A health professional may assess the condition of an individual and find that it is very necessary to use restraints so as to make the life of the individual better. However, it is not right for the health professional to decide that the patient be restrained. The nurse or the caretaker of the patient should give a suggestion to the patient so as to grant his/her consent for the use of restraints. In some cases, the behavior of a patient may require that restraints be used for the safety of the patient and the safety of other people around him/her. In such cases, the patient might not grant her/his consent regarding the use of restraints and therefore consent must be sought from very close relatives or the next of kin of the concerned person (Maher, 1992, p. 37).
In cases where a person has no proper capacity to grant consent on the use of restraints, the person’s next of kin should be consulted. When the next of kin is not available, a person who is legally the guardian of the person who requires restraint should be consulted so as to obtain his/her permission. The next of kin or the guardian should be properly informed of reasonable alternatives that make the use of restrain to be very important in a given situation. They should be informed of the type of restraint that the health care providers intend to use on the concerned person. It is also very important for health care agencies to inform the next of kin or the guardians about the benefits of a chosen type restraint and the various risks that are associated with it. This can make the guardians or next of kin of a concerned person to make informed decisions when granting permission to the health practitioners to use restraints (Britt, 2004, p. 33). If there are side effects that might be experienced due to the use of restraints, the relatives of the affected person cannot wholly blame the health practitioners because they shall have been told all the expected outcomes and the risks involved.
When restraints are used on an individual, the individual is usually denied the freedom of movement or the freedom to make his/her own decision. In most countries, it is against the law to deny people their basic human rights unless they are interfering with the rights of others. In Australia, the law states the every person is allowed to make choices and has a right to move freely. It further clarifies that every person should be ready to take risks that are associated with their free movement (Hendich, 1985, p. 37). It is therefore very important for health practitioners in aged care facilities in Australia to professionally handle the old people who are under their care in such a way that their basic rights are not infringed on. Infringement of rights of others is definitely considered as the violation of the law and it can land the health practitioners in prison. The health professionals in aged care facilities should thus use restraints according to the standards that are legally accepted and they should only be used when they the only best alternatives available.
Emergency situation may require that restraints be used on a person. For example, when a person is mentally disturbed to an extent that health care cannot be given to him/her restraints may be used to assist in the situation. When a person has fractured bones, restraints may be used so as to restrict the movement of some parts of the body and thus the person can effective receive medical attention from a health care practitioner. The affected person, the guardian or next of kin together with health care provider must be involved in the decision making process which might allow the use of a restraint. The health care professionals must also ensure that they use restraints according to the guidelines and also policies which are set out by health care facilities.
Performance measures must be developed in health care facilities where restraints are used on patients. This ensures that the use of restraints conform to the desired standards which are usually set up by relevant ministries of health in every country. Such measures also ensure that only people who are well trained and qualified are responsible for handling people whose conditions require the use of restraints. Such performance measures are usually developed by the various health care facilities. In Australia, the administrations of the aged care facilities are responsible for developing the performance measures to be used in providing care to the old people. The administrations of such aged care facilities are also responsible for ensuring that the health professionals of those facilities apply the use of restraints by following the proper guidelines and standards that are clearly stated to them. Even though most aged care facilities in Australia follow correct guidelines regarding the use of restraints, it is important for external agents to visit all aged care facilities at random so as to ensure that they comply with the rules regarding the use of restraints.
It is against the professional ethics of medical practitioners in health care facilities to use restraints as a way of punishing a patient. The health care providers should not use restraints as a way of correcting negative behaviors in a patient. In other words good behavior should not be imposed on a patient by using restraints when there are other better alternatives that can be used. Using restraints on patients with ill motives is not legal and any person found doing it should be arrested and charged in a court of law. This is one of the reasons why health professionals in aged care facilities in Australia are encouraged to observe the law when they are using restraints on the old people under their care (Fryback, 1998, p.82).
It is also against the basic human rights when health professionals use restraints on patients or people under their care for the convenience of the health professionals. For example, some people might have behaviors that make it difficult for nurses to handle them. In such circumstances, some nurses may want to restrain the concerned people so as to handle them with ease. This is a very bad motive which is unethical to the nursing profession and the health profession in general. With this regard, health professionals in aged care facilities in Australia are instructed not to use restraints for their own convenience (Smith, 2005, p. 32).
In conclusion, it is important for health agencies to create environments where the use of restraints is made as minimum as possible. This is because most people do not like themselves or their relatives to be restrained. Health professionals should only use restraints on people under their care only when there are no other better alternatives that can be used.
Reference List
Briggs, J., 2002. Physical Restraint – Pt 2: Minimisation in Acute and Residential Care Facilities. Australia: Blackwell Publishing Asia, p. 75-91.
Britt, H., 2004. General practice activity in Australia 2004-05. AIHW Cat. Canberra: Australian Institute of Health and Welfare, 29-79
Department of Health and Ageing, 2009. Quality use of medicines. Web.
Fryback, J., 1998. Counting, Using and Reducing Physical Restraints. Wisconsin: Department of Health and Family Services Licensing, p.134-201.
Hendich, G., 1985. A study of falls among elderly hospitalized patients and those in Aged Care Facilities. Australian Journal of Advanced Nursing. 2: 34-44.
Maher, L., 1992. An interdisciplinary falls consult team: a collaborative approach to patient falls. Journal of Nursing Care Quality in Australia. 21-29
Smith, R. 2005. Use of Various Kinds of Restraints in Health Care Facilities. New York: W.B. Saunders Company, p.23-39.