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Use of Restraints and Patient Safety

Restraints are a last resort to prevent harm. Nurses must use the least restrictive method, obtain proper authorisation, and monitor the patient closely.

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Key Points to Know

What you must know about Restraints & Safety

1

Restraints are used only as a last resort when all alternatives have failed.

2

Always use the least restrictive method for the shortest time necessary.

3

A physician’s order is generally required; in emergencies, apply and obtain the order promptly.

4

Monitor circulation, skin integrity, and needs (toileting, hydration) frequently.

5

Restraints must be tied to the bed frame (not the side rails) with a quick-release knot.

6

Document the reason, alternatives tried, type used, and ongoing assessments.

NMCN Exam Tips

How this topic appears in the NMCN exam

Restraints are always a LAST resort — try alternatives first.

Use the least restrictive device for the shortest possible time.

Frequent monitoring of circulation and skin is essential.

A valid order and thorough documentation are required.

Practice Question

Test yourself

Which principle should guide the nurse in the use of physical restraints?

A.Restraints should be applied routinely to all confused patients
B.Restraints are a last resort, using the least restrictive method for the shortest time✓ Correct
C.Restraints can be left in place indefinitely once applied
D.Restraints should be tied firmly to the side rails

Explanation

Restraints must only be used as a last resort after alternatives fail, applying the least restrictive method for the shortest necessary time, with proper authorisation, frequent monitoring, and documentation to protect the patient's safety and dignity.

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