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General Operational Topics

In Reply To: Use of VAlium for end of life restlessness
Next Reply: Re:Re:Use of VAlium for end of life restlessness
Next Message: Re:Use of VAlium for end of life restlessness

Post Re:Use of VAlium for end of life restlessness
Author: mrabow [CAPC/PCLC Faculty]
Date: Dec 6, 2007 6:48 pm
I'd welcome comments from others but I think it is key to document, with any intervention, that it is consistent with safety goals. Both Medicare and JCAHO are very focused on promoting safety, with fall prevention as a particular focus. Any use of benzodiazepines, especially in the elderly, would need to document very carefully that patients are not being sedated by the med and are not experiencing an increased risk of falling. I do not know of any medicare or JCAHO regulations around prevention of terminal restlessness.
Best,
Michael Rabow, MD, Associate Direcdtor, UCSF Palliative Care Leadership Center.
Replies: order by [Date] [Author] [Subject]
Re:Re:Use of VAlium for end of life restlessness (by Tom_Quinn on 12/07/2007)
The circumstances and reassessment need to be clearly and consistently documented. The JC (new name for JCAHO) or other regulator could interpret continued unsupported use of a sedative as a "chemical restraint," which requires frequent reassessment and re-ordering (can't be open ended), just as a physical restraint does. This is both a patient safety and a patient right issue for them.

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