Alternatives to Restraints and Safe Use of Restraints

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Alternatives to Restraints and Safe Use of Restraints
Module 7
Alternatives to Restraints
and
Safe Use of Restraints
Geriatric Aide Curriculum
NC Division of Health Service Regulation
1
Alternatives to Restraints and
Safe Use of Restraints
Objectives
1. Distinguish between myths and facts
about physical restraints.
2. Define physical and chemical restraints.
3. Relate the use of restraints to federal
and state laws.
4. State when restraints may be used.
2
Alternatives to Restraints and
Safe Use of Restraints
Objectives
5. Discuss the role of the nurse aide and
the family during care planning.
6. Describe the risks and side effects of
using restraints.
7. Describe the benefits of being restraint
free.
3
Alternatives to Restraints and
Safe Use of Restraints
Objectives
8. Discuss alternatives to restraints.
9. Recognize different forms of restraints.
10. Demonstrate how to apply and monitor
residents using selected physical
restraints.
4
Alternatives to Restraints and
Safe Use of Restraints
• Many long term care and other facilities
are reducing and/or eliminating the use of
physical and chemical restraints.
• Nurse aides play an important role in
reducing and/or eliminating restraints.
5
Alternatives to Restraints and
Safe Use of Restraints
6
Alternatives to Restraints and
Safe Use of Restraints
• A physical restraint is any manual method
or physical or mechanical device, material
or equipment attached or adjacent to the
resident's body that the resident cannot
remove easily which restricts freedom of
movement or normal access to one's
body.
7
Alternatives to Restraints and
Safe Use of Restraints
• The use of restraints is governed by
federal and state law.
• Restraints require a written physician
order.
8
Alternatives to Restraints and
Safe Use of Restraints
• Restraints are to be used only when
there is a medical need and only if the
restraint is the last alternative to keep
the resident and/or care team
members safe.
9
10
Benefits to Resident-Centered
Care and Freedom From Restraints
• Examples:
– Better quality of
life
– Dignity
– Less depression
– Increased
motivation
– Fewer skin tears
– Less muscle loss
– Lower care costs
– Improved appetite
– Improved hydration
11
Alternatives to Restraints and
Safe Use of Restraints
• Know the resident
– Know resident’s condition
and capabilities
– Ask family about resident’s
past, likes and dislikes.
– Share information with
nurse or during care
planning
12
Alternatives to Restraints and
Safe Use of Restraints
• Successful use of restraint
alternatives requires:
– Total care team
involvement
– Care planning
– Resident centered care
– Shift in thinking by
caregivers
13
Alternatives to Restraints and
Safe Use of Restraints
• Care planning includes:
– Physical, emotional, mental, social and
spiritual assessment of whole person
– Screening for fall risks and behavioral
symptoms
– Needs and desires of resident
– Discussion of assessments/resident
– How to adapt environment to resident
14
Alternatives to Restraints and
Safe Use of Restraints
• People’s behaviors
are an attempt to
communicate.
• Base restraint
alternative on
reason for behavior.
15
Alternatives to Restraints and Safe
Use of Restraints
• Use activities boxes for
residents who wander or
are agitated.
• Activities boxes can be
purchased or assembled
by the facility.
• The activities therapist can
give some direction about
items to put in boxes.
16
Safe Use of Restraints
• Restraints require a doctor’s order and
must be used only to treat a medical
condition.
• Never use restraints:
– As a permanent means of control
– As a form of punishment
– For the convenience of the staff
– As a substitute for activities or
treatments
17
Safe Use of Restraints
• Review definition of physical restraint: A
physical restraint is any manual method or
physical or mechanical device, material or
equipment attached or adjacent to the
resident's body that the resident cannot
remove easily which restricts freedom of
movement or normal access to one's
body.
18
Safe Use of Restraints
• Nurse aides have the most influence to
prevent incidents related to restraints by:
– correctly applying devices, and
– adequately monitoring residents when
restrained.
19
Safe Use of Restraints
• Monitor residents by
checking circulation every
15 minutes and removing
the restraint every 2 hours
for the meeting of basic
needs and repositioning
• Restraints should be a
temporary solution to a
situation
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