Mar 14, 2019

Where are the government’s changes to the regulation of physical and chemical restraints?

 

Back in January, the aged care minister said changes to the regulation of chemical and physical restraints in aged care were only weeks away.

That was nearly two months ago.

“Incidents of over use of physical and chemical restraint will not be tolerated and draft changes to regulations are expected to be released within weeks,” Aged Minister Ken Wyatt AM MP, said on 17 January 2019.

Government still working on better regulations

The government still hasn’t released draft regulations, but says it is working on them.

Minister for Senior Australians and Aged Care Ken Wyatt AM, told HelloCare, “The Department of Health is working with stakeholders to better regulate the use of physical and chemical restraint in aged care.

“This includes stakeholders from consumer peaks, provider peaks, providers, the Australian Nursing and Midwifery Federation, the Aged Care Quality and Safety Commission, the Australian Commission on Safety and Quality in Health Care, the Department of Social Services and academics.

“Consultation was undertaken on 4 March 2019, and is scheduled to meet again next week,” he said.

Advisory committee looking at inappropriate use of chemical restraint

In addition, the minister said a special advisory committee has been established.

“The Commonwealth Chief Medical Officer is chairing a Clinical Advisory Committee to consider the inappropriate use of chemical restraint in residential aged care,” the minister said.

“The Committee consists of a range of clinicians with expertise in their fields in aged care, including GPs, psychiatrist, nurse practitioners, pharmacist and geriatrician; as well as the Australian Commission in Safety and Quality in Healthcare.

“The Committee met for the first time on 26 February 2019 and explored a range of measures including education, workforce, best practice prescribing behaviours, clinical governance and alternative approaches such as diversional therapies.

“The Committee is scheduled to meet again next week.”

Physical restraint will be an aged care quality indicator

The government is also making it mandatory for all aged care operators to collect and provide data on the use of physical restraint in their operations.

“From 1 July 2019, the Australian Government will mandate the collection of three quality indicators, including the use of physical restraint, for all residential aged care providers.

“In parallel, the Department of Health will also consult with the sector on an expanded set of indicators, including medication management,” Mr Wyatt said.

Beware “unintended consequences” of changes to regulation

Juanita Westbury, Senior Lecturer, Wicking Dementia Research & Education Centre, told HelloCare that any changes to regulations must be carefully thought through.

Changes to regulations need to be “thoughtfully considered” to avoid the possibility of people finding “workarounds” and “substitutes”, and “gaming the system”, she said.

Changes to regulations can lead to “unintended consequences”, she cautioned.

Ms Westbury said when new regulations were brought in in the US, people found ways around them, and the use of psychotropic medications did not actually decline.

Please note: This image does not refer to actual people or events. Image: iStock.

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  1. Rather than radical changes to “carers “ employed at present, I would rather see placing a “patient advocate “ on all shifts. One/shift. Those advocates to be qualified nurses, even retired, that may be interested in re-employment. Same to be government employees of the dept.of health.
    A “cop on the beat” so to speak.

  2. It is disappointing to see the focus on catching staff doing bad/wrong.

    I would like to see food being used as a solution, too. When eating meals onsite with residents, I see firsthand how little some residents eat at every meal. Add to this unsuitable food, muscle weakness, ulcers from ill fitting dentures, a noisy environment, sitting beside an unfriendly resident, too light/dark, aches and pain.

    Next thing, the resident has lost weight, is restless and anxious then gets put on supplements. Not long before feeling averse to the supplements.

    Warm, nourishing hot meals, at their optimum when the resident receives it that are thoughtfully presented and high on taste. Hot healthy meals available 24/7 to provide the best opportunity to reach a daily Nutritional Quotient.

    Lets train staff to focus on finding solutions for residents, rather than solely focus on tasks. Time to really dig deep and discover the cause of distress that may also reduce the need for chemical intervention.

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