Code of Practice for Patient Restraint Methods

Restraints are used to limit the movement of a part of the patient's body or organism in order to maintain patient safety and therapeutic outcomes.

Objective

1. Restrict the body or limb activities of patients who have self-injured or may injure others to ensure patient safety and smooth treatment and care.

2. Prevent children from excessive activity to facilitate the smooth progress of diagnosis and treatment operation or prevent injury to limbs. Indications: adapted to paediatrics, high fever, delirium, coma, agitation and critical patients due to weakness, unconsciousness or other reasons when they fall off the bed, bump, scratch and other accidents or affect the nursing and treatment operations.

Operating Method

1. Assessment

(1) Review the medical record to understand the patient's condition and check the medical prescription.

(2) Patient assessment: general condition: age, vital signs, current condition, state of consciousness, treatment, presence of osteoporosis or risk factors for osteoporosis, presence of hard objects such as jewellery. Local conditions: movement of the restrained limb, presence of fractures, trauma or skin infections. The colour, temperature, integrity and local blood circulation of the skin at the site of restraint. Psychological status: whether the perception is correct, whether there is anxiety and fear (according to the condition), the degree of co-operation of the patient and the family. Health knowledge: the patient's and family's knowledge of the disease and whether they understand the purpose and necessity of restraint.

(3) Environmental assessment: whether the environment is spacious, quiet and comfortable.

(4) Assessment of supplies: Whether the restraining belt is suitable for the patient's needs and whether the supplies are complete. (Evaluation of supplies can be done during the preparation of supplies.) (5) Assessment of the operator: whether he/she understands the patient's condition and the method of restraint.

2. Preparation

(1) Preparation of materials: prepare suitable restraining tape according to the condition. Such as wide bandage, all kinds of restraining tape, several pieces of cotton pads, etc.. (2) Patient preparation: patients and their families to understand the purpose and method of restraint, to overcome fear and anxiety. (3) Environment preparation: keep the environment spacious, quiet and comfortable. (4) Operator's own preparation: dress neatly, understand the patient's condition and the method of restraint.

3. Implementation

Carry the application to the patient's bedside and check the patient's bed number, name and, if necessary, wristband. Re-explain the purpose of the restraint to the patient or family. Instruct the patient or family members on the method of co-operation, assist the patient to take the appropriate position, and select the appropriate method of restraint according to the patient's condition.

Caveat

1、Strictly grasp the indications for the use of the restraining belt and maintain the patient's self-esteem.

2、After the implementation of restraint, the patient's limbs are in a functional position, and the restraining belt is appropriately tightened and loosened, so as to be able to stretch into 1-2 fingers as a principle.

3、Close observation (30 minutes to patrol once) restraint parts of the skin condition.

4, the use of restraint time should not be too long, the need for a longer period of restraint, every 2 hours to loosen the restraint and activity of the limbs, and to assist the patient to turn over.

5、Accurate records and handover, including the reason for restraint, time, the number of restraining belt, the site of restraint, the skin condition of the restraining site, the time to release the restraint.