Hospitals and psychiatric institutions
XX
Flexible personnel planning systems must be implemented in medical facilities in order
to facilitate fast reaction to concrete conditions and existing requirements.
XX
Attention must be given to an appreciative approach when caring for persons with
mental illnesses in order to avoid a feeling of powerlessness and degradation.
XX
The prescription of PRN medication must be precise and in accordance with the legal
requirements.
2.2.3
Protection of personal
integrity
Application of measures that restrict freedom
Measures that restrict freedom are only permissible if they are applied to
avert a serious or considerable danger to the life or health of the patient or
others, or if they support medical treatment or care and are not inappropriate.
Therefore, it must be examined on a case-by-case basis whether measures that
restrict freedom are absolutely necessary to reach this goal both qualitatively
(type of measure) and quantitatively (spatial scope and duration of measure).
Restrictions of freedom can only be considered as a last resort in which case
the principle of minimum possible intervention applies.
The NPM observed in the current year under review that these requirements
regarding restraints are not always complied with in practice in psychiatric
hospitals.
Restraints in beds in
hallways and in shared
rooms
In the absence of a specially designated room, restraints were often applied
in the hallway or in shared rooms in the presence of other patients. This kind
of approach is absolutely unacceptable, as the privacy and personal space of
those affected is violated and other patients can be frightened and traumatised
when they experience coercive measures.
A similar situation is, for example, when people can see into rooms designated
for restraints. In cases like these, the NPM normally succeeded in having some
form of privacy screen installed in the relevant wards.
Furthermore, restraints are still applied in which only an abdominal restrain
(one-point restraint) is used, even though this is associated with a greater
risk of strangulation and does not comply with the specifications of the
manufacturers. The NPM still insists that 1:1 supervision is ensured if possible
in the event of a restraint. Supervision of this type would, however, be advisable
as a pre-emptive measure in order to avoid having to restrict the freedom of
the patient in the first place.
Follow-up meetings
have alleviating effect
48
Follow-up meetings after the application of a measure that restricts freedom
have an important function. They help in working through the experience and
are seen as a relief by those affected. Studies and reports from former patients
prove that follow-up meetings make it easier to cope with these experiences,
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