The use of restraints is not without identifiable psychological (to both staff and patients) or physical health risks. As listed in Table 2, physical examples include injury and aggression, pressure sores and loss of muscle tone, contractures, asphyxiation and death due to strangulation [20].
In this post
Why should we avoid the use of restraint?
The impact of restraints
A growing body of evidence shows restrictive practices may not only lead to physical injury but they can also result in long-term psychological injury. “The issue of long-term trauma is very real.
What are negative effects of restraints?
Physical restraint has impact on the patient’s psychological conditions such as helplessness, tension, anger, fear, and trauma9. The restraint action also leads to physical effects such as dehydration, choking, asphyxia, aspiration, urinary incontinence, injuries and even deaths10.
Which risks from restraints are the most common?
Restraint Asphyxia. Asphyxiation, the most common cause of restraint-related death, is termed “restraint asphyxia” in the forensic and emergency literature (11).
What are the ethical issues with restraints?
Restraints increase a person’s vulnerability to neglect, harm, and exploitation and are associated with significant physical harm and devastating psychologic consequences. The central values of respect for persons, preventing harm, and promoting positive outcomes often conflict when physical restraints are used.
What are some instances where restraints should never be used?
Restraints should NEVER be used for staff convenience or client punishment.
Restraints, from the least restrictive to the most restrictive, are:
- Mitten restraints that are used to prevent the dislodgment of tubes, lines and catheters.
- Wrist restraints that are used to prevent the dislodgment of tubes, lines and catheters.
What are misuse of restraints?
Physical, mechanical and chemical restraints and seclusion are very intrusive interventions. They can cause psychological harm, physical injury and even death. We fight against improper use of restraint and seclusion and we promote alternatives.
Why is seclusion and restraint bad?
Research shows seclusion and restraints may cause emotional suffering, injury, and a lack of trust between the patient and practitioner. While there may be times seclusion and restraint appear necessary for safety concerns, the negative impact cannot be ignored.
How do restraints effect a person physically?
The use of these restraints also poses risks to the person and require ongoing assessment and monitoring. For instance, physical restraints used to prevent falls are associated with weakness, muscle loss, and decreased balance and increased falling.
What is a risk of restraint or seclusion?
Physical restraint and seclusion pose substantial psychological and physical risk. The traumatization of coercive restraint, especially among patients with a history of trauma, may induce feelings of terror, humiliation and powerlessness [3], [4].
What are alternatives to restraints?
1) Least restrictive alternatives to restraint and seclusion include: verbal de-escalation techniques, low stimulation/decreased stimulation environments, sensory modulation interventions, use of a patient safety attendant (PSA), and implementation of a Health Care Agreement (HCA).
Which use of a restraint is inappropriate?
Additional examples of improper use of restraint may include: Statements that improper use of restraints (physical, chemical, mechanical) is occurring. Exceptional drowsiness. Unusual lethargy or inability to communicate.
When should you restrain a patient?
When are Restraints Used? Restraints may be used to keep a person in proper position and prevent movement or falling during surgery or while on a stretcher. Restraints can also be used to control or prevent harmful behavior.
Is it ethical to restrain a patient?
It should always be considered a last resort as it presents a significant threat to human rights, dignity, autonomy and wellbeing. Nurses must guard against choosing restraint, particularly when staff resources are limited. It may be the easiest option but it is rarely the most ethical.
Are restraints in hospitals ethical?
Nurses promote and advocate for the protection of patients from harm and from the potential for harm that could result from the use of physical restraints. While patients may be restrained to prevent them from harming themselves or others, this practice could result in patient harm.
How long can a patient be restrained?
The maximum length of time that you can be restrained or secluded is based on your age. If you are an adult, the time cannot exceed four (4) hours. If you are between the ages of 9 and 17 years, the time cannot exceed two (2) hours. If you are younger than 9 years, the time cannot exceed one (1) hour.
What type of abuse occurs with improper use of restraints?
In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse. Signs and symptoms of physical abuse include but are not limited to: bruises, black eyes, welts, lacerations, and rope marks.
Which statement about restraints is correct?
Chapter 13
| Question | Answer |
|---|---|
| Which statement about restraint alternatives is correct? | They are part of the person’s care plan |
| Restraints are used to: | treat medical symptoms |
| Which statement about physical restraints is correct? | They limit movement or access to one’s body |
What are 4 examples of physical restraints?
Examples of physical restraint devices include: lap belts, bed rails, Posey restraints or similar, chairs with tables attached, and chairs or mattresses that are difficult to get out of such as tip-back chairs, water chairs, bean bags and curved edge mattresses.
When can physical restraints be used?
Physical restraints should only be used in an emergency situation when less restrictive interventions haven’t been effective and the patient is at risk for harming him- or herself or others. Using restraints as a means of coercion, discipline, or convenience is a violation of patient rights.
Who can decide to restrain a patient physically?
Use of security for physical restraint within paediatrics is considered a critical incident and can only be undertaken after a multi-disciplinary agreement. Physical restraint can only be applied by staff that are deemed competent to do so.