Palm Shores fails to train staff on restraint or seclusion techniques

Palm Shores Behavioral Health Center was cited during a complaint investigation completed by the Florida Agency for Health Care Administration (AHCA) for violations of staff training and restraint/seclusion/time-out regulations. AHCA found that staff members at Palm Shores were utilizing restraint and seclusion interventions on clients without the required semi-annual training. One staff member had not received restraint and seclusion training since his/her hire date in July 2009 – almost four and a half years ago. AHCA revealed that that the “facility failed to ensure that staff who participate in the use of restraint or seclusion demonstrated competencies on a semi-annual basis [as required] for two of three staff reviewed.” Specifically, AHCA noted that “Staff A initiated a physical restraint intervention for the client on 9/25/14 and 10/20/14. Review of the personnel record for Staff A revealed a hire date of 3/10/14 and seclusion and restraint training completed on 3/20/14. AHCA also noted that “review of the record for client #3 revealed that Staff C was involved in a physical restraint intervention for the client on 10/13/14. Review of the personnel record for Staff C revealed that he was hired on 7/30/09 and last completed seclusion and restraint training on 1/15/14” almost four and a half years after the staff member’s hire date. AHCA reviewed the documentation of an emergency restraint and noted that “the client sustained 3 small bumps on his forehead while struggling to get out of the restraint- hit head against wall.” However, AHCA found “no documentation on the facility’s emergency safety intervention documentation paperwork as to who participated in the physical restraint of the client.” AHCA also cited Palm Shores for failing “to have completed documentation that the client’s record related to emergency safety interventions restraint use for three of five clients reviewed.” AHCA noted that the following documentation was not present: “documentation of the name, position and credentials of all staff involved in or witnessing the emergency safety intervention.” In the plan of correction, the facility agreed that the “Human Resources Director will maintain a spreadsheet to monitor compliance with the requirement of the semiannual competency for seclusion and restraint.” Also, the facility noted in its correction plan that “nurses have received refresher training on the completion of seclusion and restraint time out documentation.”