00:04
So, we just talked about a lot of important points
before you even consider applying restraints.
00:10
Now, it's really important to thoroughly document
anytime restraint use is in place.
00:16
So here's about 11 points,
okay, yeah I said 11,
that we've got to consider when
we're using restraint application.
00:24
So we're going to talk through these
and why they're "Oh so important".
00:28
So, first of all, one of a very important piece,
when you document someone using restraints, is
assessing the continued need.
00:36
What do I mean by this,
just because someone's in restraints,
doesn't mean that they continually need them,
for two days, six hours, three weeks, for example.
00:47
Obviously that last one's a little excessive.
00:49
But we always want to continually assess
if those restraints can safely be removed.
00:56
Now, obviously your patient condition can improve
or it can decline.
01:00
So, it's important for you to assess the
continued actual need for those restraints.
01:07
Mental status is next,
this is really important because,
sometimes a very ill patient's in restrains,
it can really make their confusion worse,
their frustration worse,
they're scared sometimes,
when they're in restraints.
01:19
So, please make sure you're assessing
this, because this is really important.
01:23
It's also important, to document the
type of restraints used and where.
01:27
When I say location, I'm talking
about did we restrain their arms,
did we restrain their legs, is it all of them,
what type of restraint are we using,
such as wrist, maybe mittens,
a restraint bed for example.
01:40
Also because something is usually
applied to someone's limbs, such as
a wrist restraint.
01:46
Circulation and sensation is really important.
01:49
Now, you can imagine,
something wrapped around your
wrist and your pulse points,
really important that the patient has
continued circulation and they can feel
and also make sure that they have
great blood flow to their limbs,
because again we've got
something restrictive on them.
02:04
And next, almost about halfway through.
02:06
Range of motion exercises.
02:09
Obviously when someone's in restraint,
they can't be walking around,
most of the time they're going
to be restrained to the bed.
02:15
So it's important with someone lying there,
as you all know, bedridden
patients, it's bad for their lungs,
it's not great for their circulation.
02:23
We want to make sure, when applicable,
that we can do range of motion
exercises to promote circulation.
02:30
Okay, so that's about halfway through,
let's talk about this last half shortly.
02:35
So, next is skin integrity.
02:37
As you can imagine,
you've got something around your wrist,
we definitely don't want to impair their skin.
02:43
Also, think about making sure their nutrition
for their skin as well is also up-kept.
02:48
Also, you can imagine if you're restrained,
eating and drinking is pretty difficult,
so is toileting.
02:55
So, it's really important as a nurse,
that you're meeting that patient's
basic needs while they're restrained.
03:00
So, making sure we're
offering fluids really often,
making sure they're assisted with eating
and making sure they're
getting toileted is applicable.
03:09
Now, restraints are really scary,
so we're almost done here.
03:12
But restraints are a really scary
situation for not only the patient,
but if my care, my loved one is being restrained
and I walk into the room,
I may not know what's going on.
03:22
So, it's really important as a nurse
to communicate with the patient and the family,
of why we're doing the restraints
and why it's necessary.
03:30
So, please make sure you
provide thorough education.
03:33
Now, for continuation of care,
restraints is a biggie that
needs to be continually assessed.
03:38
So, make sure you include
this in your plan of care
and also document the frequency,
per the agency protocol
and it's really important to
make sure you're up to date,
with your facility guidelines.