Patients in the acute phase of their illness frequently become restless and inadvertently remove feeding tubes and other essential access lines. This could be due to the patient having delirium or an acute confusional state secondary to their illness. At this stage they may lack capacity to make decisions for themselves in relation to having a feeding tube or access line inserted. If they have a feeding tube or access line in place it is vital to remember that this can be distressing. However it will only have been inserted after discussion with the patient or their carers or relatives. A Capacity Assessment must be completed to assess the Capacity of the patient. If the patient has Capacity, the patient may consent to the decision specific to the assessment. A Best Interest Decision may be completed after Capacity Assessment if the patient lacks Capacity. Refer to the Mental Capacity Act policy. The family and carers may be consulted in relation to the decision but are not the key decision makers. The mittens should be regarded as the least restrictive alternative for these patients.
This policy and supporting guideline (appendix 1) have been written to enable practitioners to follow an agreed decision making assessment and procedure process.
This clinical policy describes how Ashford and St Peter’s Hospitals Trust (ASPH) will manage the use of mittens in adult patients.
Mittens are designed to restrict the movement of one or both hands and used with patients who have removed essential lines or tubes on more than one occasion. The trust fully believes in the value of having correct mittens that are fit for purpose for these patients. Bandaging patient’s hands is not condoned.
|Compiled by:||Dee Bousfield, Stroke Specialist Dietician|
|Ratified by:||Senior Nursing & Midwifery Leadership Committee|
|Date Ratified:||March 2017|
|Date Issued:||June 2017|
|Review Date:||March 2020|
|Target Audience:||All staff|
|Contact name:||Dee Bousfield, Stroke Specialist Dietician|
- Mental Capacity Policy
- Adult Safeguarding policy
- Deprivation of Liberty Policy
- Enteral Feeding Policy