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Source:

Nursing2015

May 2003, Volume 33 Number 5 , p 32hn1 - 32hn4

Authors

  • JEANETTE SWEENEY-CALCIANO RN,C, MSN
  • ALYSSA JO SOLIMENE RN, APN,C, MSN
  • DAVID ANTHONY FORRESTER RN, PHD

Abstract

Outline

  • Abstract

  • Why use restraints at all?

  • Identifying alternatives

  • If you must use restraints

  • Documenting restraint use

  • Tips for restraint use

  • Receiving reimbursement

  • Quizzing yourself on restraints

  • SELECTED REFERENCES

  • Abstract

    Learn how simple interventions can help keep a wandering or agitated patient safe.

    Leon Minsky, 80, is in your unit to receive intravenous (I.V.) antibiotics for diverticulitis. You found him wandering the halls last night with his I.V. line pulled out. In years past, Mr. Minsky might have been considered a candidate for physical restraints. But today, physical restraints are no longer the first line of protection for patients who wander or exhibit other behaviors that could be dangerous. Researchers have found that physical restraints actually increase the incidence of patient injuries. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Centers for Medicare and Medicaid Services now require health care providers to minimize the use of restraints.

    Restraints are demeaning and potentially dangerous. Use them only when less restrictive methods fail and remove them as soon as possible. Follow JCAHO standards and your facility's policy for restraint use.

    In this article, we'll identify interventions that can reduce the need for restraints and offer guidelines for using restraints properly when they're unavoidable.

    Why use restraints at all?

    According to one study, the top five reasons nurses apply restraints are disruption of therapies, confusion, fall prevention, protection from injury secondary to wandering, and behavior management. A patient is more likely to be restrained if he has a history of unsafe behavior, needs extensive and complicated therapy (such as in an intensive ...

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