Implementation of the Duties and Powers of the National Preventive Mechanism in 2012
Special protection measures
In both hospitals erroneous filling in of forms intended for the introduction and implementation of
special protection measures were observed. When reviewing completed forms regarding the
restraint of individual patients in Ljubljana University Psychiatric Hospital, it was discovered
that, in one case, the termination of the use of restraints was not stated, while in another,
only the hour and not the date of termination was mentioned. That is why careful filling in
of forms intended for cases when special protection measures are used be proposed. In
cases of patients’ restraint lasting for more than four hours, it was proposed by the NPM that
for each prolongation it should be stated whether a patient was released and how long the
removal of special protection measures lasted. It is particularly important that the date and
exact hour of the termination of any measure be stated. Only in this manner may it be verified
if all restrictions stipulated by the ZDZdr were taken into account in the implementation
of special protection measures. Vojnik Psychiatric Hospital also explained that they had
had regular practical training sessions as far as the implementation of special protection
measures were concerned. Permanent training which enables the proper application of a
restraining measure is obviously necessary and therefore encouraged by the NPM. It was
also proposed that the NPM report together with its recommendation be included in the
training programme.
In Ljubljana University Psychiatric Hospital, at the female ward, there is one triple bedroom
that is dedicated for the purposes of using special protection measures, whilst there are two
triple bedrooms intended for this purpose on the male ward. A view of these rooms is made
possible through glass windows. There are chairs placed in front of these rooms. There is
glass installed between the rooms dedicated for the use of special protection measures on the
male ward; the glass wall may be shaded by Venetian blinds. In the NPM’s opinion, special
protection measures may only be implemented in premises dedicated for this particular use,
and the option of other patients watching restrained patients should be prevented. A special
room must therefore be dedicated for the restraining of patients where patients strapped
to beds are separated from other patients. It was thus proposed that a patient who needs
to be strapped to a bed owing to his/her (current) medical condition is accommodated in a
special room. Ljubljana University Psychiatric Hospital might also reconsider rearranging
rooms intended for the use of special protection measures into rooms for patients without
the need to be fully strapped to a bed.
The above mentioned hospital explained that medical staff are always present whenever a
special protection measure is applied. It was also communicated that contemporary European
recommendations had been followed more over the last period of time, recommending fewer
occasions of restraint in bed and more movement-friendly restraints. The advantage was
that complications were reduced while not isolating patients from the surrounding area (since
sensory deprivation worsens their condition). They would try to use restraints as little as
possible. Only those patients who need to be prevented from falling to the floor, particularly
the older patients, would be restrained in their chair. In regard to the proposal to set Venetian
blinds at the glass wall the reply was that they would be installed but their opinion was
that this was not advisable since permanent supervision could thus not be provided. The
NPM remarks that the opinion of the NPM obviously was not to limit the supervising view
of nurses over patients being committed to special protection measures. Article 29 of the
ZDZdr stipulates that a person for whom a special protection measure has been applied is
supervised, his/her vital functions monitored and is under expert treatment throughout the
time of application of a special protection measure. This is why the constant presence of the
staff and monitoring of the application of the measure is urgently needed in order to ensure
the appropriateness of its application and particularly the safety of the patient being treated
by such measure. The constant presence of the staff also makes it possible that the measure
actually lasts only for so long as it is urgently needed, and to terminate it when there is no
National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to
the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
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