safety

Select the Appropriate Type of Restraints for Various Clients (ULO 10)
Demonstrate Proper Use of Restraints (ULO 11)
Identify Various Healthcare Professionals’ Role in Obtaining an Informed Consent (ULO 12)
Discuss the Process for Obtaining an Informed Consent (ULO 13)

The classification of side rails as restraints can vary based on their use and context in patient care.

Methods:
- Use of a slip knot or immediate release buckle.
- Restraint must be applied to a movable part of the bed frame.
Assessment:
- Assess the patient every 30-60 minutes or per healthcare facility policy.
Release Protocol:
- Restraints should be released every 2 hours to allow for freedom of movement and comfort.

Use Alternatives First:
- Explore non-restraint options before considering physical restraints.
Last Resort:
- Restraints should be employed only as a last resort when necessary for safety.
Provider’s Order Required:
- A healthcare provider must order restraints, and they should not be written as 'PRN' (as needed).
- Order must include:
  - Type of restraint
  - Justification for use
  - Criteria for removal
  - Expiration date of the order
Constant Re-evaluation is Essential:
- Healthcare professionals must continuously evaluate the need for restraints.
Discontinue at Earliest Possible Time:
- Restraints should be removed as soon as they are no longer needed.
Prevent Sentinel Events:
- The application of restraints should prioritize the prevention of unexpected adverse events in patient care.
Documentation Requirements:
- Thorough documentation must be maintained concerning the use of restraints, including indications, patient responses, and evaluations.

Informed consent is the process of obtaining permission from a patient before conducting healthcare interventions. It is anchored in two key ethical principles:
- Promoting the Patient's Well-Being
- Respecting the Patient's Self-Determination
  (Refer to P. 158 for additional context)

Disclosure:
- Providing adequate information regarding the procedure or treatment.
Comprehension:
- The patient must understand the information provided to them.
Voluntariness:
- Consent must be given freely without coercion.
Capacity:
- The patient must possess the mental capacity to make informed decisions about their care.
Documentation:
- Accurately recording the process of obtaining consent in the medical chart is essential.

Protection Against Lawsuits and/or Charges:
- Ensuring informed consent protects healthcare professionals legally.
Battery:
- Performing a procedure without informed consent may lead to legal implications such as battery.
Refusal to Sign:
- If a patient refuses to sign, documentation must occur within the chart, explaining consequences of non-consent.
Sign Release Form with Witness:
- It is advisable for the consent form to be signed in the presence of a witness to ensure validity.
Responsibility for Obtaining Informed Consent:
- It must be clear who in the healthcare team bears the responsibility for ensuring that informed consent is acquired.

Illiterate Clients:
- Tailored communication strategies must be employed to ensure understanding.
Blind Clients:
- Alternative methods of information disclosure must be used.
Court-Appointed Cases:
- Situations requiring legal guardianship may not follow standard consent processes.
Life-Threatening Situations:
- Implied consent may be applicable in emergencies where the patient cannot provide consent.
Use of Translator:
- Professional interpreters should be involved when language barriers exist to ensure accurate comprehension.
Incapacitated Clients:
- Special care must be taken to obtain consent from legally authorized representatives.
Implied Consent:
- In emergencies, consent may be assumed based on the necessity of the intervention.
Minors:
- There may be different legal requirements for obtaining consent from minors depending on jurisdiction.

Taylor, C. R., Lynn, P. B., & Bartlett, J. L. (2022). Fundamentals of Nursing: The Art and Science of Person-Centered Care (10th ed.). Wolters Kluwer.