Patient Restraint In Nursing

Restraint refers to any measure intended to limit the activity or control the behavior of an individual. This can be accomplished by both physical and chemical interventions. Mittens and positional supports such as nesting beds, rolls and swaddling are not considered restraints. The physician orders the type of restraint after all other protective strategies including medical immobilization devices and alternative interventions have been assessed and determined ineffective in preventing the infant from physically harming themselves.
• Restraints will only be used after other methods of nursing intervention including soothing, comfort measures, and positional supports have been employed and proven ineffective.
• Restraints will be used if

• Prior to restraint, nurse must ensure environmental safety
• Infant kept under close observation when restrained.
a) Guarantee that a physician’s order has been provided or, in an emergency, obtain one within 24 hours after applying the restraint.
b) Concern nursing staff will check with physician regarding giving sedation to the patient. In case of sedation/medication, doctor should ensure that the orders are written in patient’s record. In case of verbal orders (if situation does not allow written order), doctor should ensure that he writes orders for medication within one hour.
c) Nursing staff will ensure safety of patient by the following safety measures:
 Lock restraint to bed frame; do not tie the straps to the side rail
 Assess restraints and skin integrity every 30 minutes
 Apply restraint to patient assuring some movement of body part. One to two fingers should slide between restraint and patient’s skin
d) Ensure that limb restraints are applied securely but not so tightly that they obstruct blood flow to anybody area or