Safe Restraint Care (Nursing)

00:04 Now that we've talked about restraints, let's talk about safe restraint care.

00:09 Now there's about nine points or so that I want to talk to you about, but I want you to pay close attention here.

00:15 This is going to be really similar to the documentation points that we noticed earlier. So because restraints, like I had told you about, can have some legal ramifications. This is really important that we provide the safest restraint care.

00:30 And again, note that many of these points are just like the documentation pieces we talked about earlier. So first, don't forget to get a physician order and renew it daily.

00:40 So restraints, typically you have to have an order every 24 hours and renewed.

00:46 Notice that renewal there, renewal has to do with making sure that restraint there's a continued need.

00:53 So that's why we don't have an ongoing order for restraints.

00:58 Now, it's really important to look at and monitor at least every two hours.

01:02 So, again, with it being a non-behavioral restraint, a medical restraint, if you will, we monitor at least every two hours, but check your specific facility.

01:12 And we've talked about this before, but family and patient education regarding use is oh so important.

01:19 So this is a very scary type of device that we can use on a patient.

01:23 They can be in a lot of distress, be very upset.

01:26 It's really upset for the family to see a patient restrained, or their loved one in restraints. So make sure you are educating, letting them know what you're doing, how you're taking care of their family and why it's needed.

01:38 And don't forget the normal ADLs or activity of daily living, such as making sure your patient is comfortable, make sure they've got food, make sure they're getting hydrated, that they can have drinks of water and toilet as well.

01:52 As you can imagine, in restraints, you can't do a lot.

01:55 You are restrained to the bed and you can't do those things for you themselves.

01:59 So make sure your patient's needs are met.

02:02 All right. On the last half, let's take a look at these.

02:05 These, again, are a lot like those documentation points that we had talked about earlier. So don't forget, if possible, range of motion exercises, so you can decrease edema, really help with circulation on your patients.

02:19 Now, skin care and positioning is really important because you can imagine you don't want your patient, and they don't want to be in the same spot for the whole time they're restrained. So making sure you reposition them for comfort and at least turn them every two hours, that also is going to help with skin care as well.

02:38 And we talked about toileting, but skin care goes with toileting.

02:41 It also goes with repositioning your patient to make sure they don't get bedsores.

02:46 And don't forget about the circulation.

02:49 Make sure you're assessing those limbs, because, again, if something's tied around someone's wrist, we want to make sure at all times that restraint, for example, doesn't get tied up on the bed rail, doesn't get somewhere it doesn't need to be, and causing excess restriction on a patient's limb.

03:05 So make sure you're doing those circulation checks.

03:08 And when I say circulation, you remember how we do that.

03:11 Check your pulse on your patient, check for warmth.

03:14 Also, check their capillary refill is a great way to do that.

03:18 And lastly, additional support is really needed.

03:21 So psychological and emotional.

03:23 Again, sometimes when we restrain patients, they don't understand why they're in the restraints. It can be really distressing and really upsetting for them.

03:32 So make sure as the nurse, you stay calm, you're there, you communicate with your client to make them feel as safe and comfortable as possible.