Quick Reference
A restraint restricts a resident’s freedom of movement or ability to access their body.
Types:
- Physical/Mechanical: Devices restricting movement, such as wrist, waist, or vest restraints.
- Chemical: Medication used to restrict movement or behavior when not required to treat a medical symptom.
- Environmental: Restrictions involving the environment that prevent freedom of movement.
Resident Rights: - Residents have the right to freedom from unnecessary restraints.
- Restraints cannot be used for staff convenience or punishment.
- When medically necessary and legally authorized, use the least restrictive approach for the shortest appropriate time.
Risks of Restraints
Physical:
- Pressure injuries and skin damage.
- Reduced mobility and muscle weakness.
- Incontinence and constipation.
- Respiratory complications.
- Entrapment, falls, or serious injury.
Emotional: - Fear, agitation, and distress.
- Loss of dignity and independence.
- Depression and reduced self-worth.
Alternatives
- Address pain, hunger, thirst, and toileting needs.
- Provide frequent observation and reassurance.
- Use therapeutic communication.
- Reduce overstimulation.
- Encourage appropriate mobility and activities.
- Use individualized environmental and safety measures.
Important Considerations
- Never independently decide to apply a restraint.
- Follow authorized orders, the care plan, monitoring requirements, and facility policy.
- Observe and report discomfort, skin changes, and circulation concerns.
- Side rails may constitute restraints depending on their purpose and effect.
- Bed and chair alarms are not substitutes for individualized fall-prevention care.
- Restraint monitoring and release schedules depend on applicable regulations, orders, and facility policy.
Related
- Patient Rights
- Informed Consent
- Fall Risk
- Patient Refusal of Care
- De-escalation & Conflict Resolution
Sources
- CNA Module 12 — Restraints
- 42 CFR §483.12 — Freedom from Abuse, Neglect, and Exploitation
Flashcards
Why should restraints not be used for staff convenience?03-application / reference-guidelines
Answer
They restrict rights and pose physical and psychological risks.
What is preferable to unnecessary restraints?01-foundations / reference-guidelines
Answer
Individualized nonrestrictive safety alternatives.