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    Understanding Restraint Use

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    Information for Patients and Their Families

    At California Pacific Medical Center, we are dedicated to maintaining an environment that respects individual rights, dignity, and overall patient well-being.

    What is the Purpose of a Physical Restraint?

    The purpose of a physical restraint is to limit free movement or access to one's body in order to prevent the patient from hurting him or herself or accidentally removing a medical device. In caring for our patients, the medical staff's first choice is to try or consider alternatives prior to placing patients on restraints. However, to keep our patients safe and to promote medical healing, physical restraints may be necessary at times. Physical restraints are only applied with a doctor's order and are a last resort when alternatives have failed.

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    Alternatives to the Use of Physical Restraints

    First, the staff will try to provide a calm and reassuring environment for the patient. Second, the staff might try or consider some of the following:

    • Reorient the patient to sense of time, place, or person

    • Reposition the patient in his/her bed

    • Take the patient for a brief walk

    • Assess for pain and provide pain relief and medication

    • Provide food or a beverage

    • Observe the patient

    • Move the patient closer to nurses station

    • Assess for medical problems

    • Place adaptive devices (for example: placing an "IV wrap" to protect the patient's IV line or setting up a bed alarm for patients trying to get out of bed)

    • Offer relaxation techniques

    • Help patient in identifying stressors that lead to violent or self-destructive behavior and developing helping strategies

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    When are Physical Restraints Most Often Used?

    • Patients who are pulling on tubes or IV lines

    • Patients who are confused and disoriented and may engage in unsafe behavior

    • Patients who put themselves or others at risk for immediate physical danger or harm

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    Keeping the Family Informed is Our Priority

    We encourage families and patients to be involved as much as possible. It is helpful to have a contact in the family to call and discuss the situation at hand and to discuss an individualized plan of care. Your experience and knowledge are instrumental in developing this plan.

    If no family members are available, the medical team will use their best judgment regarding the use of physical restraints and create an individualized plan of care.

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    Treatment Will Continue with the Use of Restraints

    If restraints are necessary, staff will provide a calm, safe environment that protects a patient's dignity and privacy. Patient care and treatment will continue.

    Staffs are trained on the proper use of restraints. There will be frequent checks by the staff to see if the restraints are still necessary. Patients will also be checked often for any reactions to restraints, and provided with meals, positioning changes, and care for hygiene and toileting needs.

    Our treatment goal is to use no restraints or the least restrictive type.

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    What are the Benefits for Using Restraints?

    • Maintain continuous medical treatment

    • Protect patients from accidental injury

    • Protect other patients and staff from harm

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    What are the Risks for Using Restraints?

    • Unintended patient injury

    • New onset pressure ulcers (bedsores)

    • Increased agitation or confusion

    • Decreased self-esteem

    • Nerve injury

    • Pneumonia

    • Strangulation/asphyxiation/death

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    Questions About the Use of Restraints

    If you have any questions or concerns, speak with the doctor, the nurse caring for the patient, or the charge nurse.

    Produced by the Center for Patient and Community Education in association with the staff and physicians at California Pacific Medical Center. Last updated: 8/09

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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