Bed Restraints Dementia Gloves Safety Hand Control Mitts Medical Bondage Locking Mittens Patients Caregivers Elderly Protectors Product, Prevent Scratching Harm, 1 Pair Dual Purpose, Black

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Psychiatric settings: Patient restraints are more commonly used in psychiatric settings to prevent patients from harming themselves or others. The use of patient restraints should be instituted only after verbal de-escalation has been attempted by trained staff. If restraints are employed, the method of restraint should be the least restrictive necessary. Mitten restraints cover the patient’s hands and are usually tied down to a bedframe or chair preventing behaviors inclusive of scratching, grabbing at others or undoing limb restraints.

Joint Commission, The. Hospital Accreditation Standards. Provision of Care, Treatment and Services. Standards PC.03.05.01 through PC.03.05.19. 2010.The American Psychiatric Nurses Association’s position statement on the use of restraint suggests a unit’s philosophy on restraint use can influence how many patients are placed in restraints. Interacting with patients in a positive, calm, respectful, and collaborative manner and intervening early when conflict arises can diminish the need for restraint. Facility leaders should focus on reducing restraint use by supporting ongoing monitoring and quality-improvement projects. Many alternatives to using restraints in long-term care centers have been developed. Most interventions focus on the individualization of patient care and elimination of medications with side effects that cause aggression and the need for restraints. Common interventions used as alternatives to restraints include routine daily schedules, regular feeding times, easing the activities of daily living, and reducing pain. [8] Gale Springer is a mental health clinical nurse specialist at the Providence Regional Medical in Everett, Washington.

Typically, if the patient can easily remove the device, it doesn’t qualify as a physical restraint. Also, holding a patient in a manner that restricts movement (such as when giving an intramuscular injection against the patient’s will) is considered a physical restraint. A physical restraint may be used for either nonviolent, nonself-destructive behavior or violent, self-destructive behavior. (See What isn’t a restraint?) Use of an enclosure bed or net bed that prevents a patient from freely exiting the bed is considered a restraint. (An exception is the age-appropriate use of an enclosed crib for infants and/or toddlers.)

Cannot be easily removed intentionally by the patient in the same manner it was applied by staff, considering the patient’s physical condition and ability to accomplish the objective [6]