Deprivation of Liberty in Intensive Care

Crews, Maryam; Garry, David; Phillips, Claire; Wong, Adrian; Troke, Ben; Keene, Alex Ruck; Danbury, Christopher

doi:10.1177/175114371401500410

Cited by 6 publications

(6 citation statements)

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“…It also provided the opportunity for healthcare professionals to provide their own view on the Safeguards. No previous studies in the published literature have examined the application of the DoLS in a palliative care context, although this subject has been explored in psychiatry16 and critical care 17…”

Section: Introductionmentioning

confidence: 99%

Palliative care clinicians' knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS)

Barry

Spathis

Treaddell³

et al. 2017

BMJ Support Palliat Care

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Clinicians working in palliative care have good levels of knowledge of the DoLS. Despite this concerns were raised, particularly by consultants; uncertainty as to when they should be used and the relevance of the Safeguards in clinical practice. Further guidance should be given to clinicians working in this specialty to ensure that clinical practice is both lawful and in the patients' best interests.

show abstract

Section: Introductionmentioning

confidence: 99%

Palliative care clinicians' knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS)

Barry

Spathis

Treaddell³

et al. 2017

BMJ Support Palliat Care

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show abstract

“…The use of DOLS is commonly restricted to, but not limited in its application solely for restraint use ( Crews et al., 2014 ) and the new principles under the LPS apply similarly. The matter of restraint use is important to discuss both from medical, nursing and allied health professional perspectives, as delirium is a fairly common occurrence among critical care patients ( Gu et al., 2019 ; Herling et al., 2018 ), whose actions may at any time prove fatal or bear significant consequences.…”

Section: Brief Review/discussion Of Topicmentioning

confidence: 99%

“…The extent of the MHA (1983MHA ( , 2007 and MCA (2005) was limited to health-care settings, such as hospitals and care homes (Crews et al, 2014); however, with the MCA (2019) in effect, this restriction has been eliminated, and the principles outlined within can be enacted to any particular setting where care delivery can take place.…”

Section: Statutory Frameworkmentioning

confidence: 99%

“…Unfortunately, with LPS, there will be a similar need to do so, even if that is more simplified under the new legislation (MCA, 2019). The period leading up the application of LPS/DOLS principles is of a “grey area” for most health-care professionals ( Baharlo et al., 2018 ; Crews et al., 2014 ), during which important decisions have to be made quickly, in particular by nursing staff to safeguard their patients from harm.…”

mentioning

confidence: 99%

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Restraint Use and Delirium in Critical Care in England and Wales: A Current Law Review

Lakatos

2020

SAGE Open Nursing

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Introduction 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. Methods 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. Conclusion 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.

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“…Crews et al 1 have summarised the current state of legislation surrounding deprivation of liberty standards (DOLS) and its impact on intensive care. They acknowledge that the law was not intended for use in the intensive care setting, but confirm that we must comply with it.…”

mentioning

confidence: 99%

Deprivation of liberty standards in intensive care medicine

Brown

2015

Journal of the Intensive Care Society

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Deprivation of Liberty in Intensive Care

Cited by 6 publications

References 1 publication

Palliative care clinicians' knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS)

Palliative care clinicians' knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS)

Restraint Use and Delirium in Critical Care in England and Wales: A Current Law Review

Deprivation of liberty standards in intensive care medicine

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