Overview
The complainant (Mr C) made a complaint about Grampian Health Board (the Board) on behalf of the aggrieved (Mrs A). Mrs A was admitted to Aberdeen Royal Infirmary (the Hospital) after collapsing in a supermarket on 17 February 2009. On the following day, it was recorded that she was very agitated, confused and that she was shouting. Later that day, nurses recorded that they were unable to give the prescribed intravenous antibiotics because Mrs A refused them. The records show that she was subsequently given two doses of haloperidol (an antipsychotic drug) by intramuscular injection 'to settle'.
Specific complaints and conclusion
The complaint which has been investigated is that Mrs A was injected with haloperidol against her will on 18 February 2009 (upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) undertake an external peer review in the Hospital to include: the assessment, treatment and care of people with confusion, delirium or behavioural disturbance; the use of the Adults with Incapacity legislation; the use of both physical restraint and restraint by medicines;
- (ii) review the means by which medical and nursing staff are trained in the assessment and management of acute agitation or confusion, including appropriate use of the Adults with Incapacity legislation and documentation;
- (iii) review and disseminate their 'Guidance for Rapid Tranquilisation of Psychiatric Emergencies in Psychiatric Hospitals, General Hospitals and Accident and Emergency Departments' document;
- (iv) remind all clinical staff in the Hospital to carefully document indications for the use of sedative medication, the patient's consent to such treatment and the use of any form of restraint to administer such medication;
- (v) provide me with details of the findings and the action plan created as a result of the above recommendations and provide updates where relevant;
- (vi) ensure that the findings in this report are communicated to the staff involved in Mrs A's care and treatment; and
- (vii) issue an apology to Mrs A for the failings identified in this report.
The Board have accepted the recommendations and will act on them accordingly.