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Excellence Every Day

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Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.
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A focus on restraints
balancing the safety needs of patients with the least restrictive methods

MGH NARRATIVES
Kathryn Eagan headshot
Candice Couture, RN

Reducing length of stay one creative idea at a time
When you’re in need of acute care, the best place to be is in the hospital. But once the
urgency has passed, patients recover better in their own homes or in a less-acute care
facility. Staff on Ellison 12 recently employed a strategy in caring for Mr. J that both improved care and reduced the amount of time he spent in the hospital
. ... read more

Candice Couture, RN, staff nurse, General Medicine, and PCS Restraint Solutions in Clinical Practice Committee member


Restraint Use in the Surgical ICU: How to balance out competing safety needs ... read more

Jeanne Dolan, RN, MSN, staff nurse, Surgical ICU


Sometimes comfort comes in the form of trust, respect, and compassion ... read more

Katherine (O’Meara) Jacobson, RN, staff nurse, Cardiac Step Down Unit

MGH RESTRAINT RESOURCES

 

 

 

IMPROVEMENT INITIATIVES
FYIs

 

 

 

Overview
MGH strives to reduce the use of restraint across patient care areas and identify safer interventions for our patients whose behaviors put them at risk for injury.  Success in this endeavor requires a comprehensive approach with attention to regulatory and professional standards, healthcare team knowledge and attitudes, practice traditions, scientific evidence, and individual patient needs.  A partnership among clinical, regulatory, and technical experts helps to ensure that systems are in place to support effective communication and compliance. This partnership is reflected in two MGH committees working hand in hand: The Collaborative Governance Restraint Reduction Committee and Restraint and Seclusion Solutions Team.

MGH Restraints and
Seclusion Solution Team

There are ethical concerns and patient safety risks associated with restraint use in acute care hospitals. These concerns are reflected in CMS and Joint Commission standards which are very specific, particularly in the area of nursing and physician assessment and documentation. The MGH Restraints and Seclusion Solution Team, co-led by Carol Camooso Markus, RN and Tony Weiss, MD, is a multidisciplinary team of nurses, physicians, and administrative staff, convened in 2010 to explore innovative ways to meet regulatory requirements. Building on earlier work done in the Emergency Department, the team developed templates to provide triggers for clinician assessment and documentation. Outcomes to date include the recently implemented restraint “stickers” for nurses, POE enhancements for providers, and nurse and provider educational efforts. Current monitoring data shows further improvement is necessary. This Team will continue explore ways to promote compliance and educate clinicians.
More about the MGH Restraints and Seclusion Solution Team

Policies, Procedures & Guidelines:
(internal access only)

Restraint and Seclusion

SPOTLIGHTS ON PRACTICE

Trialing Sensory-based Interventions in the SICU
The MGH Restraint Solutions in Clinical Practice Committee was formed in 2011 as part of an institution wide effort to safely reduce the use of restraints. One of the goals of this multidisciplinary team of nurses and occupational therapists is to assess the potential for sensory-based evaluation and interventions to prevent or reduce restraint use in the acute non-psychiatric inpatient units...more

Sensory Room photo

Effects of Sensory Interventions on an Inpatient Psychiatric Unit
A patient’s experience of hospitalization and the symptoms related to mental illness may reduce the capacity to manage negative moods and emotions and lead to a loss of behavioral control. This, in turn, may result in the use of patient restraints and/or seclusion to maintain patient safety....more

Blake 11, Inpatient Psychiatric Unit

EXTERNAL REVIEWERS

Joint Commission logo
National Patient Safety Goal 14.01.01
Pressure Ulcers (Risk assessment tools, preventative actions)

Joint Commission Accreditation Manual

CMS logo
Centers for Medicare and Medicaid Services (CMS)

Magnet Recognition

Magnet_logoThe American Nurses Credentialing Center (ANCC) requires Magnet-designated organizations to track nationally-benchmarked nursing sensitive indicators (NSIs) to continually inform improvement efforts related enhancing patient outcomes. Examples of NSIs include, but are not limited to: patient falls, hospital-acquired pressure ulcers, blood stream infections, ventilator-associated pneumonia, and restraint use.

Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.
If you have questions or suggestions related to the EED portal, please contact Georgia Peirce at (617) 724-9865 or via email at gwpeirce@partners.org.

Updated 2.6.19

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