Vision of freedom restricting measures

A freedom restricting measure is a drastic measure for patient, caregiver and third parties alike.

For this reason, in our hospital we strive for a fixation-poor policy in which the application of a freedom restricting measure is seen as an exceptional measure. Only if it has been shown that there are no alternatives to guarantee the safety of the patient, treatment and the safety of others, will freedom-restricting measures be considered.

• Seclusion/isolation room: An isolation room with camera surveillance is available in the emergency department. Only when the patient poses a danger to himself and/or others is this used. The isolation room may also be used to reduce emotional and/or sensory stimuli and thereby prevent altered behavior. The emergency physician must always approve the use of the isolation room.
• Coercive medication: Coercive medication means the administration of medication (e.g. sedative medication) against the patient's will. This medication is administered by the care team and this is always done after consultation and on the prescription of the attending physician. This is done only to prevent harm to the patient, another or to the environment. Stimuli are reduced and a regulation of the urge to move takes place. The administration of this medication is stopped as soon as possible and the family/representative is informed.

Basic principles of freedom restricting measures:

• Each patient should be approached with dignity, autonomy, integral well-being and degree of self-reliance.
• Restraint of liberty is only possible if the patient is a danger to himself and/or others.
• The application of freedom restricting measures will only be done after:
  • consultation with a minimum of one fellow nurse and/or the attending physician.
  • consultation and consent of the patient and/or legal representative and/or family.
• The restriction of freedom will always be kept as short as possible, and will be re-evaluated daily.
• The measure of restraint is always documented in the patient's care record.
• Fixation is carried out on the basis of a clear procedure.