Legal Eagle Eye Newsletter for the Nursing Profession (7)2 Feb 99
Quick Summary: One-on-one continuous in-room supervision is not required when the physician orders close supervision. It was not a lapse in judgment not to restrain this patient while she slept.
The nurses provided appropriate care by maintaining close supervision through periodic checks of the patient in her room and by putting her in a room within eyesight of the nurses station. COURT OF CLAIMS OF OHIO, 1998.
Living at home the patient became irrational and forgetful. The family had a social worker see her. The social worker believed there were mental changes occurring which compromised the patients ability to live independently. The social worker called the police to take the patient to the geriatric psych unit of an acute-care hospital.
At the hospital the patient was diagnosed with dementia and agitation. Ativan was ordered prn for agitation. When she became agitated, the psych nurses caring for her gave the Ativan.
The nurses got the patient out of bed and into a geri chair, where she slept for a few hours. They put her back to bed, where she slept the rest of the morning. She was awakened for lunch, which she refused, but she took her meds.
She was looked in on mid-afternoon. A few minutes later she was found on the floor. She had fallen trying to get out of bed. A lawsuit resulted, but the suit was dismissed by the Court of Claims of Ohio.
The court ruled that close supervision of a dementia patient being sedated with Ativan for agitation does require periodic checks on the patient, but close supervision does not require continuous one-on-one in-room supervision. The court praised the nurses for putting this patient in a room near the nurses station. The court did not fault the nurses for not restraining this patient while she was asleep in her room. Barnett v. University of Cincinnati Hospital, 702 N.E.2d 979 (Ohio Ct. Cl., 1998).