Patient Restraints and Other Alternatives

Restraints

A restraint is anything that prevents or limits a patient from being able to move their arms, legs, or body freely. Common types of restraints include soft mitts and soft wrist or ankle restraints. A soft mitt is a large glove that covers the hand. A soft restraint is a device that is placed on the wrist or ankle with Velcro.

Why Restraints are Used

Restraints are used when there is behavior that causes immediate danger to the safety of the patient, staff members, or others. A soft mitt prevents the patient from being able to grasp things, but they are still able to move their arms. Soft wrist and ankle restraints may be used to prevent a patient from interfering with cares, such as pulling at an IV or other tubes or removing a dressing.

When Restraints are Used

Restraints are only used after all other options have been tried. Other options are:

• A bed or chair alarm.

• Skin “sleeves” to limit access to IVs and other devices.

• Comfortable room temperature and minimal noise.

• Intentional rounding. This includes using the bathroom, repositioning, and checking on pain control and comfort on a regular basis.

• Encourage family and friends to provide company, distraction, and other activities.

• Remind the patient of where they are, and why they are here.

• Provide regular activity, such as sitting up in a chair or walking in the hallway (as able).

• Remove any lines, tubes, and drains that are not needed.

• Constant observation:

  • Video monitoring

  • Personal safety attendant

Supporting Patients with Restraints

The nurse can explain why the restraints were placed and what needs to happen to have them removed.

Help orient the patient to their surroundings:

• Who you are

• What day it is

• Where they are

• Why they are restrained

Offer comfort. Hold their hand, talk to them, and/or tell the staff about any needs. The nurse will be assessing the patient often.

Restraints Removal

Restraints will be removed as soon as possible. It will depend on the patient being able to follow the plan of care or no longer a safety threat to self or staff. This may be when all the lines, tubes, or drains are removed, or when the patient is able to follow directions.