Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.
What are restraints?
Restraints are methods used by trained healthcare providers to stop or limit a patient's movement. Restraints may be used without the patient's consent.
Why does the patient need restraints?
Restraints may be needed so healthcare providers can safely provide immediate and necessary care. Healthcare providers will try to calm the patient before they apply restraints. If the patient does not cooperate with healthcare providers, restraints may be needed so they can examine and treat him. A patient who is violent or agitated may need restraints so that he does not harm himself or others. Restraints may also be needed if the patient tries to remove lifesaving equipment, such as IVs or breathing tubes.
What types of restraints may be used?
- Physical restraints are devices that limit specific parts of the patient's body, such as arms or legs. Belt or vest restraints may be used to stop the patient from getting out of bed or a chair.
- Chemical restraints are medicines used to quickly sedate a violent patient. These will be given as a pill or an injection.
- Seclusion is placing the patient in a room by himself. The room is locked and kept free of items that could cause injury. Healthcare providers will watch him at all times when he is in seclusion.
How will healthcare providers monitor the patient while in restraints?
- Vital signs, such as heart rate, breathing rate, and blood pressure, will be taken often to make sure they are in normal range.
- The patient's physical comfort will also be monitored closely. Healthcare providers will check the patient's skin for injury or blood flow problems under the restraints. They will also give him liquids and take him to the bathroom as needed.
- The patient's behavior will also be monitored. Healthcare providers will remove physical restraints or allow the patient to leave seclusion as soon as he is calm and cooperative.
What are the risks of using restraints?
The patient may become more angry or violent while in restraints or seclusion. The patient may struggle against physical restraints. This can cause skin wounds or block blood flow. It can also increase the patient's heart rate and breathing rate. This can be life-threatening.
Chemical restraints can cause low blood pressure, heart rhythm problems, and slow or shallow breathing. This can affect how much oxygen the patient gets. Chemical restraints can also cause drooling, shuffled walk, muscle spasms and stiffness, and tremors.
Care Agreement
A patient has the right to safe care and to be treated with respect. Patients have the right to help plan their care. To help with this plan, patients must learn about their health condition, how it may be treated, and when restraints may be needed. Treatment options should be discussed with healthcare providers. Patients and healthcare providers can work together to decide what care may be best.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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Medical Disclaimer
FAQs
Restraints should not cause harm or be used as punishment. Health care providers should first try other methods to control a patient and ensure safety. Restraints should be used only as a last resort. Caregivers in a hospital can use restraints in emergencies or when they are needed for medical care.
What are the rules for using restraints? ›
Restraint and seclusion should not be used as a means of punishment or convenience. Generally, restraints and seclusion cannot be administered longer than 4 hours for adults (> 18 years), 2 hours for children and adolescents (9 - 17 years), or 1 hour for children (<9 years) unless state laws are more restrictive.
What should be monitored when restraints are used? ›
The patient restrained for the management of violent or self-destructive behavior will be under continuous observation with documentation by a NA/Sitter of patient activity every 15 minutes. Nurse will document a nursing assessment to include respiratory status, circulatory status, range of motion, and behavior.
What is required before applying a restraint to a person? ›
An order from the patient's physician must be obtained. The physician must visibly assess the patient within 24 hours after the restraints are applied. 3. Consent must be obtained from the patient, the patient's next-of-kin, or the Durable Power of Healthcare.
What are the three considerations for using restraint? ›
Three considerations for using restraint or seclusion, according to the ABAI's position statement, are: Welfare of the individual, right to choose, and least restrictiveness. Punishment is an acceptable therapeutic intervention if you cannot block delivery of the reinforcer.
What is the most serious risk of restraint use? ›
The most serious risk is death from strangulation. Restraints affect dignity and self-esteem. restraint causes illness, injury, or death. ➢ Restraints must protect the person.
What are legal risks of using restraints? ›
If restraints are placed, the physician has a duty to protect the patient and should fill out all appropriate paperwork as they have decided to take away the patient's liberty. Use of restraints may precipitate issues of battery and false imprisonment.
What are 5 risks associated with restraints? ›
Physical restraint can cause harm and serious injuries. Physical restraint often causes problems such as: • loss of strength and falls • pain • constipation or incontinence • pressure injuries (sores) • panic, fear and anger • isolation and loneliness • loss of dignity • injury and death.
How often do you check a person in restraints? ›
6 Check on restrained patients at least every 15 minutes. Remove the restraint at least every two hours to check for skin irritation and proper blood circulation, exercise the joints that are inhibited by the restraint and determine whether the device is still necessary.
How often do you check PT in restraints? ›
∎ During initial use of mechanical restraint, observe/monitor the patient's condition at minimum every 15 to 30 minutes.
Furniture shoved against a bed to block movement. Wheelchair user shoved in front of a table, unable to move. Putting the vulnerable adult in a room and locking the door.
Do you need consent for restraints? ›
Informed consent is required prior to all non-emergent restraint use. The health professional who is proposing the restraint or is in the best position to discuss the restraint requirement, is responsible for obtaining and charting voluntary and informed consent or refusal.
Do you need patient consent for restraints? ›
Nurses cannot use restraints without patient consent, except in emergency situations when there is a serious threat to the individual or others.
When should restraints not be used? ›
Restraints must not be used for coercion, punishment, discipline, or staff convenience. Improper restraint use can lead to serious sanctions by the state health department, The Joint Commission (TJC), or both.
When should a restraint be avoided? ›
Persons with delirium may display behaviors that risk injury or interference with treatment. There is little evidence to support the effectiveness of physical restraints in these situations. Physical restraints can lead to serious injury or death and may worsen agitation and delirium.
What do you assess for restraints? ›
Documentation
- patient behavior that indicates the continued need for restraints.
- patient's mental status, including orientation.
- number and type of restraints used and where they're placed.
- condition of extremities, including circulation and sensation.
- extremity range of motion.
- patient's vital signs.
- skin care provided.
Key Messages The aim of this policy is to provide direction for staff in relation to the use of restraint. The Policy aims to provide a decision making framework which will support staff in balancing their duty of care, with the rights of the patient and the rights of staff to protect themselves from harm.
What are the rules for restraints in nursing? ›
Order requirements for restraints require an in-person assessment by the provider within 24 hours of the restraint order, and restraint orders are only good for 24 hours at a time. That means that if the patient continues to need restraints, a new order must be given every 24 hours.
Which of the following items must be part of an order for a restraint? ›
Orders for restraint/seclusion must contain the following elements: 1. Date and time 2. Reason for restraint/seclusion 3. Type of restraint/seclusion to be used 4.
What is the CMS policy on restraints? ›
482.13 (e)
All patients have the right to be free from physical or mental abuse, and corporal punishment. All patients have the right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff.
