Mary, an 85-year-old patient with cognitive impairment and gross insta

QUESTION

Mary, an 85-year-old patient with cognitive impairment and gross instability, wanders continuously. Lately, she has fallen twice, and the family demands that she be restrained.

As the unit manager, you have initiated a least restraint practice. An appropriate action in this situation would be:

a. Setting up a nursing team meeting to review practices.
b. Calling the family to inform them of the practice.
c. Initiating a multidisciplinary and family meeting to focus on Mary’s needs.
d. Restraining Mary to satisfy the family’s wishes.

ANSWER:

ANS: C
Crossing the Quality Chasm emphasizes the importance of rendering care with the client (client-centered) rather than to the client. In this situation, the patient includes family in transparent discussions about quality needs and takes a team approach that involves healthcare professionals, the family, Mary’s needs, and evidence associated with safe practice.