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Restraints

Restraints. CHAPTER 14. Objectives. Describe safe/appropriate methods for the application of restraints (SRD) Discuss nursing interventions that are specific to the patient requiring a SRD Detail measures to create a restraint-free environment

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Restraints

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  1. Restraints CHAPTER 14

  2. Objectives Describe safe/appropriate methods for the application of restraints (SRD) Discuss nursing interventions that are specific to the patient requiring a SRD Detail measures to create a restraint-free environment Identify common SRDs used in a health care setting Describe the differences between chemical and mechanical restraints Outline facility protocol when applying restraints

  3. Restraints Used as protective devices to limit physical activity (client/body part[s]) Classified as physical or chemical Physical restraints are any manual method of physical/mechanical device, material or equipment attached to the clients body

  4. Restraints… Chemical restraints are medications such as neuroleptics, anxiolytics, sedatives, psychotropic agents used to control socially disruptive behavior The purpose of restraints is to prevent the client from injuring self or others

  5. Restraints… Determining the need for safety measures is viewed as an independent nursing The use of restraints has legal implications because the use restricts the client’s freedom Nurses should be familiar with agency’s policies and state laws regarding restraints

  6. Restraints… The US Health Care Financing Agency (HCFA) has published (1999) revised standards for the use of restraints These standards apply to all health care organizations and specify two important standards

  7. Behavior Management Standard …the client is a danger to self or others The nurse may apply restraints, however the nurse must be in contact with a physician or a licensed independent practitioner within 1 hour. The initial restraint order is valid for only 4 hours; client is reassessed.

  8. Behavior Management Standard… If restraints continue to be necessary, the client must be kept under visual and auditory monitoring Orders are renewed daily

  9. Acute Medical/Surgical Care Standard …the temporary immobilization of a client related to a procedure The medical/surgical care standard permits up to 12 hours to obtain a physicians written order for the restraint All orders are renewed daily

  10. Restraints… Before selecting a restraint, nurses should understand the purpose and measure it against the following criteria… Least restrictive as possible Least obvious to others

  11. Nursing Interventions Frequent checks Take patient out of restraints q 2 hours Check Color Temperature Movement

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