Extensive research has shown that physical restraints cause more harm that good, and can usually be avoided.
Physical restraints are often used when older patients are confused and pull at intravenous lines or nasogastric tubes, or when unstable patients try to get out of bed unassisted.
At times, this cannot be avoided, yet . . . some hospitals and nursing homes are entirely restraint-free! Patients have injured themselves struggling against restraints or when entangled after getting partway out of bed.
Death has resulted from restraints.
To better understand restraints, try being tied up for a while.
Restraints delay recovery, cause de-conditioning, and create psychological trauma.
Ideally, one can reduce restraints if there is closer observation by nurses, but this is not always practical since resources are limited.
However, there are strategies that may work. Simple things make a big difference.
Often we keep IV lines and Foley catheters in patients longer than we really need them.
Scheduled toileting improves mobility and decreases incontinent episodes (and bed changes).
Getting out of bed may improve eating and bowel function, and lessen the need for NG tubes.
Reduced restraint use is a key quality indicator. |
