Welcome to Episode 93

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Tip of the Week– Patient Restraints

There has always been a dilemma on the use of patient restraints. Its main purpose is to promote patient safety by reducing the risk to injure themselves or others. The Joint Commission released different standards for restraint and seclusion depending on the situation that restraints are used to address.

Restraints may be indicated for patients with behavioral issues who pose a risk for injury to oneself or to others. In these cases the Behavioral Health Care Restraint and Seclusion Standards apply.

Patients who do not have behavioral problems but have a condition that requires the need for restraints like confusion and agitation, the Acute Medical and Surgical (nonpsychiatric) Care Restraint standards would be followed.

Since restraints render the patient immobile, complications may rise from it so it is important that the use of restraint would do more good than harm. Also, a patient under restraint should be continuously assessed for the following:

  • signs of injury associated with the application of restraint
  • nutrition and hydration status
  • circulation and range of motion of extremities
  • vital signs
  • hygiene and elimination
  • physical and psychological status and comfort
  • readiness for discontinuation

The standard set also requires that an individual who has been under restraints should be evaluated face to face by a licensed independent practitioner (LIP) within 1 hour. In crisis situations where an LIP is unavailable, a trained registered nurse or a physician assistant could perform the 1-hour rule assessment. However, an LIP or the physician caring for the patient should be consulted on the evaluation the soonest time possible.

Join Commission Provision of Care, Treatment and Services

Safe Patient Handling

JCAHO Patient Safety Index


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