Freedom restricting measures are (physical or verbal) measures used to deliberately restrict the freedom of the patient in question. Many forms of freedom restricting measures fall under this definition, including but not limited to: involuntary treatment (e.g. forced medication) physical restraints (side rails fully up) physical fixation (arm restraints in order to prevent removal of drip) electronic surveillance to monitor the whereabouts of the patient. In hospitals, these often include the use of side rails, a cushion belt (around the waist) or a Posey bed. Often sedatives are administered in combination with the freedom restricting measures. For small children it often involves fixation of e.g. hands to prevent the extraction of a nasogastric tube. The Vereniging Verpleegkundigen & Verzorgenden Nederland (V&VN) [Dutch Nurses and Carers Association] published a set of guidelines for nurses to implement these restraints in hospitals. The ‘Wet BOPZ’ [Dutch Psychiatric Hospitals (Compulsory Admissions) Act] protects the rights of clients who are involuntarily admitted into mental healthcare, services for the disabled and in geriatric psychiatry. The act only applies to ‘BOPZ’-marked facilities and also applies to some (closed) wards in nursing homes. Mental healthcare facilities use a national registration system to register the restraints called Argus registration. Permission of the patient or his/hers legal representative is required before starting freedom restricting measures. The patient’s high-risk behavior providing cause for the restraints is not described in this concept.
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