RESTRAINTS Restraints and Restraint Alternatives Restraint Any manual

RESTRAINTS

Restraints and Restraint Alternatives Restraint Any manual method, physical or mechanical device, or material or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs or head freely. Restraint Alternative Devices or techniques employed to avoid the use of restraints. Depending on the intent and how it is used, it can be an alternative or a restraint.

Examples of Restraints Mitt Restraint Wrist Restraint Jacket Restraint

Examples of Restraint Alternatives

Restraint or Restraint Alternative? • Patient one is alert, oriented, and able to remove a lap belt on her own. You and the patient agree the best way to remind her to ask for help to the bathroom is to use a lap belt. • Patient two is an older gentleman with a UTI and some confusion. He’s left handed but his left arm is contracted due to a stroke. He can’t remember to ask for help out of the chair so you used a lap belt and chair alarm.

Escalating Progression • Prevention- Distraction • Alternative- Covering the line • Less Restrictive- Self-release lap belt • More Restrictive- Lap belt patient cannot release • See Box 27 -13 p. 385

Prevention- Environment • Repositioning • Alarms • Sitter at bedside • Low Bed • Decrease stimulation • Swaddling (infants)

Prevention- Diversion Activities • Conversations • Videos • Lego's • Fold Towels • TV Channels • Ambulate

Padded Lap Belt Restraint or Restraint Alternative?

Freedom Splint Alternative

Alternative Low Bed

Soft Hand Mitt Alternative

Soft Hand Mitt Restraint

Restraint Quick-Release Limb Holders

Vest Restraint

Soma Safe Enclosures Restraint

On-going Monitoring • Patient Comfort – – Food Hydration Toileting ROM • Continuation/Discontinuation – Mental Status – Cognitive Functioning – Level of Distress/Agitation • Patient Safety – – Vital Signs Circulation Checks Skin Integrity Correct Application

Criteria to Discontinue Restraints • Able to follow directions • Able to participate in care • Able to participate in program • Behavior improves/changes • Lines tubes discontinued • Positive response to medication intervention