Staff in all nursing homes should be trained in the use of restraint devices, a jury at Dublin City Coroner's has said. Kitty Holland reports.
The recommendation came following an inquest yesterday into the death of Ms Ellen Murphy (74), who died at St Gabriel's nursing home in Edenmore, Dublin, in March 2003. She had been resident there for 18 years.
The court heard Ms Murphy died when a restraining device got caught around her neck and strangled her as she was trying to get out of bed.
Ms Joanne O'Brien, one of two care assistants on duty on the night of March 18th, 2003, said she was in charge of the 31 patients on the first floor that night. Ms Murphy was one of her "high priority patients" as she was "very unsteady on her feet". In the previous weeks she had become particularly unsteady, and there had been a policy of restraining her during the day. In the last week they were also restraining her at night as she was inclined to wander and fall.
The restraint device was a piece of foam with straps that were secured to the frame of the bed, looped underneath and tied on either side, with the foam padding on the patient's stomach. Ms Murphy had extricated herself from the device, however, "by sliding out underneath".
At 6 a.m. on the morning of March 19th, Ms Murphy bleeped Ms O'Brien as she needed to be changed. Ms O'Brien did this, having to remove the restraint to do so. When finished, she replaced the device and did so "exactly the way I found it".
"I was never shown by anyone at St Gabriel's how to use this. I basically left it the way I found it."
At about 6.45 a.m., she went to check on Ms Murphy, and found her sitting on the floor, her back against the bed, with the restraint device around her neck. At that stage "I screamed for Elnora".
Ms Elnora Alngohuro, the nurse on duty that night, said when she got to the room she lay Ms Murphy on the floor. "She was still quite warm, I started performing CPR, and was pressing on her chest. I asked Joanne to get the oxygen machine from downstairs." Despite their efforts Ms Murphy died.
Deputy matron Ms Siobhán Murphy, was called to the home at 7.15 a.m. The Dublin city coroner, Dr Brian Farrell, put it to her that despite her judgement that a restraint was necessary to keep Ms Murphy safe, "it seems she could get out anyway".
"I think the restraint wasn't on properly," she answered. "If it's used properly it's safe." She had not been aware Ms Murphy had extricated herself from the device before.
State pathologist Ms Marie Cassidy gave cause of death as ligature strangulation.
The jury of four men and two women said all nursing home staff should be trained in the use of all restraint devices, that this be recorded by date, along with who gave it and who received it.
