Restraints are protective devices used to immobilize or restrict a patient's movement to protect the patient or others from harm, are only used as a last resort with a doctor's order, and require close monitoring of the restrained patient's circulation, skin integrity, and mental status.
Restraints are protective devices used to immobilize or restrict a patient's movement to protect the patient or others from harm, are only used as a last resort with a doctor's order, and require close monitoring of the restrained patient's circulation, skin integrity, and mental status.
Restraints are protective devices used to immobilize or restrict a patient's movement to protect the patient or others from harm, are only used as a last resort with a doctor's order, and require close monitoring of the restrained patient's circulation, skin integrity, and mental status.
Restraints are protective devices used to immobilize or restrict a patient's movement to protect the patient or others from harm, are only used as a last resort with a doctor's order, and require close monitoring of the restrained patient's circulation, skin integrity, and mental status.
either attached are adjacent to the patients boy and are used for immobilization or restricting the activity. PURPOSES
To protect the immediate safety of the patinet
or others. To prevent patients from falling.
To prevent interruption of therapy.
To prevent a confused patient form removing
any life support equipments. To reduce the risk of injury to others TYPES OF RESTRAINTS TYPES INDICATIONS IMAGES
1.MITTENS RESTRAINTS •Patient who scratch
themselves or pull out tubes.
2. LAP OR BELT IN THE •Patients at risk of sliding or
CHAIR falling form the chair. 3. BED RAIL OR SIDE RAILS •Patient at risk of fallings.
4. CHAIR WITH BELT •Patient at risk of
wandering or falling.
5. ABDOMINAL BELT •Patients at risk of falling or
self-harm. 6.WRIST RESTRAINT •Patient at risk of pulling out the tubes.
7. ELBOW RESTRAINT •Patients at risk of pulling
out the tubes.
8.MUMMY RESTRAINT •To restrict the movement
of the limb in small children during procedures. HAZARDS OF RESTRAINTS Tissue damage due to constant friction. Damage to other parts of body such as dislocation. Development of pressure sores. Never damage or ischemia. Foot drop or wrist drop. Asphyxia or aspiration pneumonia. Patients feel that he or she is punished. GENERAL INSTRUCTIONS Explain the need for application and type of restraints. Consider the emotional impact of application on family and friends. Restraints shouldn’t be applied without doctors order. Consent should be obtained before application of restraints. Restrains should be used with greatest care. Circulation must not be occluded. Pad the bony prominences.
While applying restraints, see that the normal
body position can be assumed. Untie the restraint at least every 4 hours.
Patient with restraint should be visited at least
every 30-60 minutes. Skin folds should be clean and dry prior to application of restraint. Ensure that there are no wrinkles in restraints. NURSES RESPONSIBILITES Monitor a patient in restraint every 15 minutes for: signs of injury, circulation and rage of motion , comfort and readiness for discontinuation of restraint. Documentation every 2 hours. Assess the clients behaviour and the need for restraint and applies as a last resort. Get written order and obtain consent as per hospital policy. Must communicates with the client and family members. Explain the client the reason for the restraint and cooperation. Arrange adequate assistance form competent staff before carrying out the restraint procedure. Apply the least restrictive, reasonable and appropriate devices. Arrange the client under restraint in a place for easy, close and regular observatin. Particular attention to his/her safety, comfort and dignity, privacy and physical and mental conditions. Attend the clients biological and psychosocial needs during restraint at regular intervals. Review the restraint regularly or according to institutional policies. Consider the earliest possible discontinuation of restraint. Document the use of restraint for record and inspection purposes. NURSING PROCEDURE Check the physician order. Identify the patients. Explain the procedure to the patients and his/her relatives. Allow the patient to ask question and encourage his/him to participate in the procedure as much as possible. Ensure patients privacy. Wash and dry hands. Arrange the articles near the patients bed side. Make sure that the restraints are correct size for the patients build and weight. Obtain adequate assistance to manually restrain the patient. Mummy restraint: The child is placed in an open blanket which is adjusted in such a way that one edge is under the child's neck and another extends beyond its feet. The child's arms are placed by the sides.
Elbow restraint:
Elbow is extended, padded and bandaged with
a wooden spatula placed on the anterior or flexor aspect, Jacket restraint: The jacket is put on the child keeping the laces at the back, so that child cannot touch them The long tapes on the jacket are fixed to the under structure of the crib. Clove-hitch restraint: The wrist or ankle is placed in the loops of device. The ends of the device are pulled to make it firm and tied to the cot frame. It should be tight enough to prevent slippin off the hand or foot. After an hour placing a restraint, the patient should be evaluated. The nurse assigns a qualified staff member to observe the client. Conduct an assessment of the patients, a) Vital signs, respiratory status , circulation , skin integrity and mental status. b) Provides relief from restraints by releasing one limb at a time and providing active range of motion exercise. c) Provides hydration, food and toileting. d) Evaluates the need for continuation of restraints. If restraints are no longer needed the nurse releases the patient form restraints before the physicians order expires. Wash hands. Replace the articles. Document the procedure. i. Events that led to the use of restraints. ii. An alternative intervention attempted and patients responses. iii. Time of initiation and time of discontinuation of restraints, clients mood and psychomotor behavior.
