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Use of restraints
Restraints in the medical setting are items that limit a patient’s movement. Restraints can help keep patients from harming themselves or anyone else, including their caregivers. They are used as a last resort.
When you hear about restraints, you might think of devices such as belts, vests, jackets, and mitts for the hands. You might also think of restraints that keep a patient from being able to move their elbows, knees, wrists, and ankles. Other ways to restrain a patient are:
- A caregiver holding a patient in a way that restricts the patient’s movement
- Giving medicines to a patient against their will to restrict their movement
- Placing a patient alone in a room or area that they cannot leave on their own
When Are Restraints Used?
Restraints may be used during surgery or when a patient is on a stretcher to hold them in the right position and keep them from falling.
Restraints can also be used to control or prevent harmful behavior.
Sometimes hospital patients who are confused need restraints so that they do not:
- Scratch their skin
- Remove catheters and tubes that give them medicine and fluids
- Get out of bed, fall, and hurt themselves
- Harm other people
Restraints should not cause harm or be used as punishment.Health care providers should first try other methods to control a patient and keep them safe. Restraints should be used only as a last choice.
Caregivers in a hospital can use restraints in emergencies or when they are needed for medical care. When restraints are used, they must:
- Limit only the movements that may cause harm to the patient or caregiver
- Be removed as soon as the patient and the caregiver are safe
A nurse who has special training in using restraints can begin to use them, but a doctor or another health care provider must be told restraints are being used. They must then sign a form before the restraints can continue to be used.
Patients who are restrained need special care to make sure they:
- Can have a bowel movement or urinate when they need to, using either a bedpan or toilet
- Are kept clean
- Get the food and fluids they need
- Are as comfortable as possible
- Do not injure themselves
Patients who are restrained also need to have their blood flow checked to make sure the restraints are not cutting off their blood flow. And, they need to be watched carefully so that the restraints can be removed as soon as the situation is safe.If you are not happy with how a loved one is being restrained, talk with someone on their medical team.Restraint use is regulated by national and state agencies.If you want to find out more about restraints, contact The Joint Commission at www.jointcommission.org. This agency oversees how hospitals are run in the United States.
Comprehensive Accreditation Manual for Hospitalswithin theManaging Human Resourcesstandards. A standard FAQ publication of The Joint Commission. Dec 24, 2009. Accessed Feb. 26, 2012.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.