RESTRA.

lNTS

PRESENTED BY-
MS. SHOBHANA SHRIIWAS
M.SC NURSING FINAL
YEAR
 DEFINITIONS
• Restraint is defined as 'the intentional restriction of
person's voluntary movement or behavior. (Counsel
and Care UK, 2002)
• Restraints are physical, chemical or
environmental measures used to control the physical
or behavioral activity of person portion of his/ her
body .
 PURPOSE
-
• To carry out the physical examination.
• To provide safety.
• To protect from injury.
• To complete the diagnostic and therapeutic
procedures.
• To maintain the patient in prescribed positio ·:
INDICATIONS-
• Displaying behavior that is putting themselves at risk of harm
• Displaying behavior that is putting others at risk of harm
• Requiring treatment by a legal order, for example , under
the Mental Health Act 2007
• Requiring urgent life-saving treatment
 GENERAL PRINCPILES
• Should be selected to reduce client's movement only as
much as necessary.
• Should carefully explain type of restraint and reason for
its use.
• Should not interfere with treatment.
• Bony prominences should be padded before applying it.
• Always select the safe and appropriate restraint.
• Restraint should not be too tight; it should not
interfere with the normal circulation.
• Restraint should demonstrate to gain the
cooperation and reduce the anxiety.
• Should be attached to bed frame not to side rails.
• Change the side to prevent pressure sore
• Observe the restraint every 20-30 minutes to prevent
any complications.
• Should be removed a minimum of every 2 hrs.
• Do the recording and reporting properly.
TYPES OF
RESTRAINT
.
PHYSICAL RESTRAINT- ENVIORNMENTAL RESTRAINTS

Physical restraint is Environmentalrestraints

anything near or on the body
which limit a clients that change or modify a
movement. this may be person's surroundings to
attached to a person body or
create physical barriers restrict or control a client's
*E.g -table fixed to a chair or mobility
a bad rills that can not be
opened by a client E.g. A secure unit or garden,
seclusion
 CHEMICAL RESTRAINT
Chemical restraint are any forn of
psychoactive medication usi not to
treat i11ness, but to intentionally
inhibit a particulc behavior or
movement.
 TYPES OF PHYSICALRESTRAINT-
1. Mummy restraint
2. Elbow and knee
restraint
3. Extremity restraint
4. Abdominal restraint
5.
6. Jacket
Mitten restraint
or finger
restraint .

7. Crib net restraint

8. Safety belt
9. Slide rails and splints
 Elbow restraint

knee restraint
Mummy restraint
 Extremity
restraint

Abdominal restraint
Jacket restraint
Crib net restraint-
Safety belt-
SLIDE RAILS AND SPLINTS-
 POTENTIAL RISKS AND SIDE EFFECTS OF RESTRAINT USE
Psychological /Emotional
• Increased agitation & hostility.
• Feelings of humiliation, loss of dignity.
• Increased confusion.
• Fear.
• Pressure ulcers, skin trauma.
• Decreased muscle tone, strength, endurance.
• Contractures, loss of balance & Dislocations/ fracture.
• Reduced heart and lung capacity.
• Increased constipation, increased risk of fecal
• Physical discomfort, increased pain Increased
constipation, increased risk impaction.
• Increased incontinence and urinary stasis.
• Obstructed and restricted circulation.
• Reduced appetite, Dehydration.
• Impaired Circulation.
• Death.
 RESTRAINT GUIDELINES
• Use only after written order by the physician, unless emergency
situation occurs.
• Patient is reassessed every 24 hours for continued need for restraint.
• New order is required after 24 hours.
• No standing order allowed.
• Physician and nurse must document in their notes the indicat.io . restraint.
• Type of restraint to be used.
• The projected time restraint is to be employed.
 ROLE OF NURSE-
 Check for circulation, condition of limbs.
 Attention should be given to patient's need
including hydration, elimination and nutrition.
,
 Vital signs.
 Follows instructions, directions.
 Calm, in control.
Asks for assistance.
Monitor signs for injury.
Maintain comfort of the patient.
Readiness for discontinuation of restraint.
Release the patient, turn and position freque
Role of nurse continue...

• Follow institute a trial of restraint release.

• Maintain hydration and nutritional need.
• Proper reporting and documentation.