Restraints - Faces, Feelings and Emotions

To be sure that we are constantly monitoring and improving with regard to use of patient restraints:

1) Viewpoints of patients who have experienced restraint or seclusion are incorporated into staff training and education to help staff better understand all aspects of restraint and seclusion.

2) Whenever possible, such patients contribute to the training and education curricula and/or participate in staff training and education.

RESTRAINTS

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Like a three-legged stool - Appropriate use of restraints involves the patient, family, and staff.

Research has shown that each “leg of the stool” has many faces/reactions/emotions regarding restraints

Patients Reactions to Being Restrained

Quotes from

numerous journal articles

“After a while I gave up; I became like a mouse.”

““It made me very sad.”

“If there was a fire, I’d be caught. How would I get out?”

“I have done nothing to deserve this [restraints]. I feel like a POW!”

“Why am I being held like a prisoner ?”

Families/significant others may have mixed reactions to their loved

ones in restraints.Quotes from Journal articles & family members of our patients

“Can’t you tie her down? I worry that she’ll crawl out of bed and fall.”

“She has never acted like this before, what have you done to her?”

“Oh my gosh, is she always going to be this way?”

One group that may be overlooked are the STAFF

Actual quotes from numerous Journal articles

“I am always concerned for the patient’s safety, I’m also concerned for the patient’s dignity during the restraint and seclusion process. I work diligently to ensure that both the patient’s dignity and respect is maintained.”

“ I feel guilty at times because you take away the patient’s freedom and that bothers me. I also worry about a patient hurting himself by pulling out lines or tubes.”

How the staff can make placing a patient in restraints easier and less

traumatic on everyone:1. EDUCATE: Be sure that the patient and the family members

are told and understand the specific reason for placing the patient in restraints. Assuring the family that the least restrictive method to keep the patient safe is used.

2. COMMUNICATE openly with family members informing them whenever possible that their family member is placed in restraints. Offering repeated reassurances and explanations to help alleviate the patient’s and family’s concerns.

3. ACCOMMODATE: Attend to patient’s and/or family’s needs. Allow an opportunity for questions, concerns or goals.

4. Include Families: Encourage families to participate more fully in the patient’s care in an effort to produce a safer environment without the use of restraints:

• being aware of and controlling stimulation and noise

• sitting with love ones

5. Evaluate: Check the need for continuing or discontinuing restraints.

Module revised annually with input from staff, patients and family members.

Reviewed & Revised 2/05; 1/06; 1/07; 2/08

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