unit 15 restraints

8/14/2019 Unit 15 Restraints

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DHSR Approved Curriculum-Unit 15 1

Unit 15

Restraints

Nurse Aide I Course


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Restraints

Introduction

(continued)

When alternatives to restraints are

not effective, however, and the

physician orders restraints, it becomes

essential for the nurse aide to know the

risks involved in caring for theseresidents.


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15.0 Identify and discuss the safety

precautions to be consideredwhen using restraints.


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Facts Regarding Restraints

Ordered by the physician whennecessary to treat a medicalsymptom or provide emergency

medical treatment Choice of restraint based on

multidisciplinary evaluation for the

least restrictive measure


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Facts Regarding Restraints(continued)

Types of acceptable restraintshand or mitts

soft ties for wrists and anklesvests and safety beltslap cushions

lap trays


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Types of unacceptable restraints

using bed rails to keep residentfrom voluntarily getting out of bed

tucking in top sheet so tightly thatresident cannot move

using wheel chair safety bars toprevent resident from getting outof chair


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Types of unacceptable restraints(continued)

placing resident in wheel chair soclose to a wall that the wallprevents resident from getting outof chair


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Reasons for use of acceptablerestraints

Temporarily for life threateningmedical conditions

Brief periods to allow medicaltreatment to proceed if there is

documented evidence of residentor legal approval of treatment


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15.1 List eight considerations that

would be important when usingrestraints.


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Considerations When Using

Restraints

Used to protect residents and not toaid staff

Restraints require physicians order Need for restraint should be

apparent (unnecessary use is false

imprisonment)


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Restraints

(continued)

Staff must provide for the restrainedresidents basic needs, with specialattention to elimination needs


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Restraints

(continued)

Secure enough help to apply

restraints quickly to prevent injury

Use reassurance in an attempt to

calm agitated residents in restraints

Apply according to manufacturersdirections


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Safety Measures For Restrained

Residents

Check on resident frequently

Apply restraint only after you have

received instructions in its use Protect bony areas and skin by

padding them prior to applying

restraint Adjust restraint so that it allowssome movement, but is secure


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Residents

(continued)

Use slip knot to tie restraint for quick

release

Secure restraints to bed frame, not

to side rails


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Residents

(continued) Loosen restraint, stay with resident,

and use call signal to notify

supervisor immediately:when unable to detect a pulse in

restrained extremity

when fingers/toes are cold, pale or

blue in color


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Residents



supervisor immediately (continued):

if resident complains of pain,

discomfort, numbness, or tingling in

restrained part


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Residents



supervisor immediately (continued):

when skin appears red or

damaged under restraintwhen breathing is impaired with

vest or safety belt restraint


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Residents

(continued) Carry scissors in pocket to

cut restraints in emergency

situations

Remove restraints for 10

minutes and repositionresident every two hours


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Residents

(continued)

Be sure resident needs are met when

restrained Keep call signal within residents

reach


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Residents

(continued)

Recording restraints should include:

The type of restraint wrist

ankle

waist belt

mitt

vest


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Residents

(continued) Recording restraints should

include (continued):

Time restraint appliedEach time restraint loosened

and resident repositioned

Time restraint removed

Condition of resident


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Residents

(continued) Observations and reporting should

include:

Color and condition of skin under

restraint

Pulse rate, color and temperature ofskin in restrained extremity


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Residents

(continued) Observations and reporting should

include (continued):

Any complaints about restrainedpart

Red or injured skin areas under

restraintRespiratory rate and color of skin

with vest and safety belt restraints


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15.2 Demonstrate the application of

restraints.


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15.3 Demonstrate the application of a

safety belt restraint.


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15.4 Identify a sampling of alternatives

to avoid the use restraints.


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Alternatives To The Use Of

Restraints

Using friends, family,volunteers or sitters

Diverting with interesting

activities Answering call signal

promptly

Exercise and outdooractivities


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Alternatives To The Use Of

Restraints

(continued) Electronic warning devices on

beds and doors

Consistent reality orientation andstaff assignments

Having room close to nurses

station


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DHSR Approved Curriculum Unit 15 35

unit 15 restraints

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