According to Ruth Craven, Constance Hirnle, and Sharon Jensen in Fundamentals of Nursing Human Health and Function a restraint is used to stop a patient from being able to move freely, whether it be physically or assisted with medication. Types of restraints include physical, chemical, nonviolent/self-destructive, violent/self-destructive, and seclusion. Ultimately restraints are used in situations to help keep both the patient and the staff caring for that patient safe. The purpose of this paper is to recognize and explore ways to improve the use of bed restraints and further educate nurses on proper use to enhance patient safety. This is relevant in today’s healthcare setting, because there is still a need to keep patients safe and provide them with quality care, which may include the use of restraints.
There has been debate on whether or not restraints are safe for patients. Tammelleo (1992) states that the use of restraints cause approximately 200 deaths every year, some of which include instances where a restraint was not necessary for the patient. Misuse is another important factor in the safeness and effectiveness of bed restraints. Misuse and tragic accidents have lead to the involvement of the FDA and recommendation calls that every medical institution must have and practice protocols for proper use of restraints (72). Tammelleo goes on to discuss recommended alternatives that should be explored before resorting to the use of restraints. Restraining patients may seem like the easier and quicker way to handle a patient, it is not always the best. Some alternative measures include wedging pads or pillows against the sides of a wheelchair to keep the patient in a good position, soften lights, provide soft music, spend extra ...
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...s well as the protocol for them at each facility. Ultimately restraints are an effective way to ensure the safety of patients as well those providing care to them. As long as measures are taken to educate faculty on the proper use of bed restraints they will continue to provide quality care to those in need of them.
References
Clark M. (2005). Involuntary Admission and the Medical Inpatient: Judicious use of Physical Restraint. MEDSURG Nursing, 14(4), 213-219.
Craven, R., Hirnle, C., Jensen, S. Fundamentals of Nursing Human Health and Function. (7th ed., pp. 584-586). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Kerzman, H., Chetrit, A., Brin, L., Toren, O. (2004). Characteristics of Falls in Hospitalized Patients. Journal of Advanced Nursing, 47(2), 223-229.
Tammelleo, A. D. (1992) Restraints: A Legal Catch-22? RN, 22(4), 72-76.
This assignment will explore a case study on an episode of care where a patient with chronic pain was hoisted. This will be written from the perspective of the author, a student nurse. The purpose of this assignment is to underline the ethical, legal and professional issues surrounding the episode of care during nursing practice and how these issues influence the role of the nurse and their professional judgement in delivering holistic, person-centred care for the patient. The author will cover the complications on delivering care when healthcare professionals should consider and respect the patient’s decisions and personal preferences whether it may benefit the patient or not. Therefore, the author will argue the principles of the patient’s autonomy against the concerns for the patient’s health and well-being, considering what form of care is appropriate and what must be done and how the nurse can maintain their professional role in being an advocate. Moreover, this will consider the nurses’ approach in providing the best care possible by means of ethical, legal and professional values. Furthermore, this assignment will briefly show an awareness of the roles of other professionals involved in the care.
In addition, the charge nurse needs to reinforce the safety check among nurses in regular basis. On the other hand, nurses are spending a great amount of time on charting their assessments outside the patients’ rooms. Knowing that every patient room is equipped with a computer, nurses can complete all their nursing risk assessment at the patient’s bedside in order to provide some supervision to the patients especially clients at high risk for falls and injuries. Furthermore, nurses are great educators. Teaching patients how to use their call bell during admission and have the patient demonstrate back is a big intervention to encourage patients to press the call button when help is needed instead of getting out of bed on their
Physical restraint, according to Health Care Financing Administration, can be defined as any handling, physical and mechanical methods applied to a patient with the aim of denying him or her the freedom of movement or access to his or her own body (Di Lorenzo et al., 2011). It may involve use of belts or ties that restrain movement of an individual such as seclusion. Seclusion refers to isolation from others, often done in a room that’s I avoid of any furniture and has a small observable window as the only connection to the outside world (Chandler, 2012). The use of physical restraint in handling patients has been on debate for several years now. In most countries such Italy, it
Seclusion and restraint started out in psychiatric hospitals and have now evolved into many schools. Restraint started out in England in the mid 19th century after having a history of poor conditions. Since Americans did not open up their first state- run mental hospital until 1822, they were unaware of the negative history that happened during the British reformation ("Human Side of Hospitals"). The American physicians thought that the restraints were keeping their patients safe when it was actually mistreatment of their patients. Anything that can be used to restrict the movements of a patient is a form of restraint. Things used as restraints can be leather or velcro wristlets or anklets that are used to hold the patient or attach them to their bed, lock them in their room, or by using sedating chemicals.
This literature review is focusing on discussing the effects of seclusion and restraints on treatment consequences of patients in mental health area. Seclusion and Restraint are used for controlling the behavioral patterns of the mentally ill patients in different surroundings consisting of psychiatric management facilities and hospitals (Kentley, 2009). Over past decade, comprehensible consensus has come out that seclusion and restraints are secure interventions of last alternative and application of those interventions should and can be diminished significantly (Knight, 2011). However, recent studies indicated that it is traumatic for patients experiencing or witnessing restraint and seclusion traumatic; patients can feel high levels of anxiety, fear, and anger once aware that restraint is going to take place, sometimes it could resulting in an exacerbation of patient’s mental status (Stewart et al, 2010). Due to the humanitarian, ethical, and legal issues which could lead to, seclusion and restraints are known as the most controversial management strategies (Holmes, Kennedy & Perron, 2004). Previous studies and researches could not analyze this topic adequately; thus, further researches and studies related to the effects and risk managements of using seclusions and restrains will be discussed in below.
...l. "[The Use Of Physical Restraints In An Acute Care Hospital]." Assistenza Infermieristica E Ricerca: AIR 23.2 (2004): 68-75. MEDLINE. Web. 22 Oct. 2013.
Huey-Ming Tzeng, PhD, RN, Chang-Yi Yin, Nurses' Solutions to Prevent Inpatient Falls in Hospital Patient Rooms. Nurs Econ. 2008;26(3):179-187. View at:
Nursing surrounds the concept of patient care physically, mentally and ethically. The therapeutic relationship that is created is built on the knowledge and skills of the nurse and relies on patient and nurse trusting one another. The use of nursing skills can ensure these boundaries are maintained, it allows for safe patient care. Professional boundaries are the line that nurses cannot cross, involving aspects such as patient confidentiality and privacy, ensuring legal aspects of nursing and the boundaries put in place are not breached. However, nurses accepting financial or personal gain from patient can also cross these professional boundaries. It is only through education in this area that the rights of patients can be preserved, as well as the nursing standards. Through education in areas such as confidentiality, boundaries can remain in tact and the patient care can remain within the zone of helpfulness.
Proponents of physical restraint believe that the use of it can assist healthcare providers in treating geriatric patients with conditions ranging from dementia to incontinence. Utilizing medical restraints is necessary for the well-being of patients, as it will be more beneficial for them. However, opponents of physical restraint argue that it causes more harm than good. Along with the physical and psychological trauma that it may bring, it also violates a person's autonomy and decision-making. While the main goal of using restraints is to assist a patient and prevent harm from occurring, the opposite may happen from a mishap by inexperienced or immoral practitioners.
Since, seclusion is a matter conflicting between patient's rights and safety, this issue becomes one of great concern for mental health professionals. If seclusion becomes necessary, then it is important that throughout the seclusion the patient receives a high level of nursing care in a way which maintains their
Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency coordination task force with the help of government agencies. These government agencies are responsible for making health pol-icies regarding patient safety to which every HCO must follow (Schulman & Kim, 2000).
Restraints limit a patient’s movement. This brings up many ethical debates and issues. There are certain guidelines that should be followed when it comes to using restraints. It is important to know the different kinds of restraints, how to apply a physical restraint properly and how to administer a chemical restraint safely. It is important to consider alternatives as the use of restraints can present risk and negative outcomes.
Safety is a primary concern in the health care environment, but there are still many preventable errors that occur. In fact, a study from ProPublica in 2013 found that between 210,000 and 440,000 patients each year suffer preventable harm in the hospital (Allen, 2013). Safety in the healthcare environment is not only keeping the patient safe, but also the employee. If a nurse does not follow procedure, they could bring harm to themselves, the patient, or both. Although it seems like such a simple topic with a simple solution, there are several components to what safety really entails. Health care professionals must always be cautious to prevent any mishaps to their patients, especially when using machines or lifting objects, as it has a higher
we support our clients right to make their own decisions and secure their healthcare rights. Also informing them about the “speakup “ campaign in cases where they are being cared for in an unsafe manner. “Doing for” involves the nurse’s responsibility to do for the patients, what they would normally do for themselves but cannot do it at that time due to limited ability; either because they are in pain or disabled in any way as a result of their present illness, accident, or similar situations that results to, or is related to, activity impairment(s). Doing this helps them physically and emotionally. Meanwhile, it is important to maintain their dignity while doing things for them because their limitations can elevate their risk of emotional and psychological problems.
A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages from restraining could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). Educating nurses may reduce restraint usage by increasing knowledge, changing attitudes, and providing alternatives to treatment. Policy changes within the facility could also be needed along with education to reduce restraining patients when an alternative could have been used.