Exploring Ethically Sensitive Decision-Making in Acute Hospital Care

Project leader:

Dr Jane Williams, Consultant Nurse in Stroke Care

Location

Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust

Summary of initiative:

Patients in the acute phase of their illness frequently become restless and inadvertently remove feeding tubes and other essential lines. This phenomenon is particularly common in ITU and in patients with neurological conditions such as stroke or head injury. Retaining methods and interventions (additional taping, application of hand bandaging or mittens and the use of alternative fixing devices, for example nasal loop) are in use. These methods are forms of restraint and, as such, are ethically sensitive and fraught with emotion for the patient, their family and for staff. Such tensions have to be managed alongside the need to provide optimal treatment.

This project will explore the use of hand control mittens in three groups of patients; ITU, acute stroke and head injury within an acute hospital setting. The trial of the hand mittens with three patients in each setting will involve the use of semi-structured questionnaires to gain the views of patients (where possible and appropriate), next-of-kin and the key team members to enable the issues relating to the use of this form of restraint to be explored from different perspectives.

The findings from this project will be used to inform the development of a local policy and guidelines to ensure that transparent and consistent decision-making processes are followed.

Report

Download the FoNS Dissemination Series Short Report (PDF 103KB)

For further information about this project please contact: jane.williams@porthosp.nhs.uk

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