Restraint Use Health Article

Definition

A restraint, or physical restraint, is a piece of equipment or device that restricts a patient's ability to move. Restraints may keep a patient from getting out of bed or moving arms and legs excessively.

Purpose

Restraints are used to control a patient who is in danger of harming the self or others. It is sometimes necessary to restrain children who may not be capable of remaining still when they are frightened or in pain during some procedures. The use of physical restraints in the health care arena should be used as a last-resort option.

Precautions

Many safety measures should be considered before applying restraints. According to federal law, first and foremost is the need to try other methods to promote safety and avoid the use of physical restraints. Some examples of alternative methods are patient reorientation to physical surroundings; discussion with family and friends about staying with the patient; moving the patient's room nearer to staff members; teaching relaxation techniques in order to decrease anxiety and fear; and decreasing overstimulation. Documentation of these methods is extremely important.

Description

Several types of medical manufacturers have different names for the same types of physical restraints. The most common names and types of physical restraints are:

• soft wrist and ankle restraints
• strap fastening vest (posey jacket)
• seat belt with buckle (restraint belt)
• mittens (restraint mitts)
• leather wrist and ankle restraints

The most common reasons for the use of physical restraints are:

• When a confused patient roams through the health care facility endangering him/herself.
• When a confused patient tries to remove medically necessary tubes, intravenous lines, or protective dressings.
• When a patient has an unsteady gait (walk) and is at risk for falls.
• When a patient needs to be kept from inflicting self-harm or injury (suicidal).
• When a patient needs to be kept from inflicting harm upon health care workers, other patients, and/or visitors (homicidal).
• When a professional is performing minor surgical procedures on a child that is not able to remain still.