Lakatos Attila
Manchester Royal Infirmary, Manchester University NHS Foundation Trust.
SAGE Open Nurs. 2020 Jun 22;6:2377960820931286. doi: 10.1177/2377960820931286. eCollection 2020 Jan-Dec.
This is a law review of restraint use in critical care settings within the United Kingdom with a specific context to England and Wales following the introduction of new statues and case law developments. The principles discussed could be similarly applied internationally, as the aim of health care is the preservation of life. Care delivery often proves difficult without the use of restraint considering the adversities delirium may present with as a common occurrence. Staff have to be aware of their role, duty, and limitations in legal terms and respond to challenging behavior appropriately and proportionately within the law.
As a law review, it follows arguments and principles around a topic by analyzing case law and statutory instruments specifically applicable to restraint use within critical care.
Restraint use in critical care settings in England and Wales is justifiable prior to formal authorization regardless the patient has or lacks capacity at the time as long as the restraint use is to maintain life-sustaining treatment or where an action could result in potential deterioration in the condition of the patient. However, there is a need to distinguish between on-going and life-sustaining care provisions. Restraint use in any case has to be in order to protect the patient from harm, enacted in the best interest of the patient, and has to be proportionate with the perceived likelihood of severity of likely harm occurring. Unless the delirium lasts or likely to last for over 28 days, no formal application is required should the need arise. Staff are empowered by statutory and case law measures to act with the use of appropriate restraint to protect their patients and those in close vicinity from harm. Regardless of national jurisdictions, the aim of critical care is to preserve life; hence, the findings within could be applicable internationally.
这是一篇关于英国重症监护环境中约束措施使用的法律评论，特别针对英格兰和威尔士在新法规及判例法发展后的情况。所讨论的原则在国际上也可类似适用，因为医疗保健的目标是挽救生命。考虑到谵妄作为常见情况可能带来的不利因素，如果不使用约束措施，护理工作往往会变得困难。工作人员必须清楚自己在法律层面的角色、职责和限制，并在法律范围内以适当且相称的方式应对具有挑战性的行为。
作为一篇法律评论，它通过分析特别适用于重症监护中约束措施使用的判例法和法定文书，围绕一个主题展开论证和阐述原则。
在英格兰和威尔士的重症监护环境中，在获得正式授权之前使用约束措施是合理的，无论患者当时是否有行为能力，只要使用约束措施是为了维持维持生命的治疗，或者某项行为可能导致患者病情潜在恶化。然而，有必要区分持续护理和维持生命的护理规定。在任何情况下，使用约束措施都必须是为了保护患者免受伤害，以患者的最大利益为出发点，并且必须与所感知的可能发生伤害的严重程度相称。除非谵妄持续或可能持续超过28天，否则如有需要无需进行正式申请。法定和判例法措施赋予工作人员权力，使其能够在使用适当约束措施时采取行动，以保护患者及其附近人员免受伤害。无论国家司法管辖区如何，重症监护的目标都是挽救生命；因此，本文的研究结果在国际上可能适用。
