Module K

Restraint

Method used to restrict movement or behavior

Physical restraint

Device or method that limits movement and cannot be easily removed

Chemical restraint

Drug used to control behavior or restrict movement

Restraint free care

Environment where restraints are not used

Restraint alternative

Method used instead of restraints

False imprisonment

Unlawful restriction of a resident’s freedom

Resident rights

Right to be free from restraints and treated with dignity

Examples of restraints

Wrist restraints vest mittens seat belts pelvic supports

Facility restraint practices

Side rails locked wheelchair tucked sheets walker out of reach

Criteria for restraints

Doctor order last resort least restrictive consent monitoring

Risks of restraints

Injury pressure ulcers aspiration strangulation infection emotional distress

Aspiration

Breathing food or liquid into lungs

Strangulation

Choking causing lack of oxygen and possible death

Contracture

Shortening of muscles causing limited movement

Nurse aide role restraints

Follow care plan meet needs ensure safety encourage independence

Maslow hierarchy

Framework prioritizing basic needs first

Check frequency

Resident checked every 15 minutes

Safe application

Leave slack pad areas secure properly

Release restraints

Every 2 hours for at least 10 minutes

ROM with restraints

Perform range of motion exercises

Emergency scissors

Used to quickly remove restraints in emergencies

Restraints never used

For convenience or punishment

Doctor order required

Restraints must have physician approval

Least restrictive method

Use safest option with most freedom

Monitor resident

Check vital signs hydration and breathing

Provide alternatives

Use activities repositioning and supervision instead of restraints