Safety Restraints

Safety Restraints

General Information
■ Restraints are any physical or pharmacological means used to restrict a Pt’s movement, activity, or access to his/her body.
■ Restraints are used only as a last alternative after all other methods of control have been attempted prior to application.
■ Restraints can only be used to prevent Pts from harming themselves or others, or interfering with medical treatment.
■ Restraints may never be used for staff convenience or discipline.
■ The application of restraints requires a written physician order specifying the clinical necessity, type of restraint, frequency of assessment, and duration restraint is to be used.
■ Use of restraints should not exceed 24 hours. Note: Always refer to specific agency’s policy and procedure when using restraints.

Procedure (Physical Restraints)
■ Informed consent should be obtained from Pt or family.
■ Obtain a written physician order must be renewed every 24 hours.
■ Always use the least restrictive form of restraint available.
■ Assess skin and circulation, sensation, and motion (CSM) of area to be restrained prior to application.
■ Pt should be restrained in an anatomically correct position with all bony prominences adequately padded and protected to prevent the development of pressure sores.
■ Follow manufacturer’s instructions when applying restraints.
■ Apply loosely enough for two fingers to fit under the restraints.
■ Restraints must not interfere with medical devices or treatment.
■ Restraints should be secured to chair or bed frame (Never to side rails) using quick-release knots. For adjustable beds, secure to the parts of the bed frame that move with the Pt.
■ A call bell must be easily accessible to the Pt.
■ Assess restraint sites (skin, distal circulation, etc.) q 15 min.
■ Remove restraints every 2 hours if possible. For aggressive Pts, remove only one restraint at a time.
■ Document findings and interventions after each assessment.

Alternatives to Restraints
■ Provide regular orientation to reality and diversional activities.
■ Encourage family to be involved with diversion and supervision.
■ Allow ample opportunity for supervised ambulation and toileting.
■ Move Pt closer to nurse’s station. Monitor more frequently and respond to call lights promptly.
■ Utilize pressure-sensitive alarms in beds and chairs or sitters.
■ Conceal tubes and lines with pajamas or scrubs.