If a patient is at risk for falling they may refuse to call for assistance. If a patient is clearly a danger to himself or herself and others, restraints may be indicated. The family or the physician may refuse to allow or write an order for them. The nurse must document that the need for them was communicated, to whom and the response. Even with adequate care being given accidents can happen with legal consequences.
Nursing homes are currently the focus of intense governmental supervision and regulation.
The effectiveness of the regulation is debatable. If this approach is to be paralleled to eliminating medical malpractice, a solution may be a long way off. What can be anticipated is increased pressure from the government, from consumers and the courts. This will result in increased litigation and increased pressure on nursing home staff and facilities. Each member of the nursing staff would be wise to document carefully daily care and especially incidents that result in injury.