Restraints.pptx

Restraints application and contraindications

1. Restraints

2. SAMRUDDI COLLEGE OF NURSING GOKAK

3. A ss i gnm e nt o n R e s t r a i n t s S ub m i tt e d t o Mr.Basavaraj Navi sir Submitted by M a h a mm a d y a s ee n M u ll a B s c N u r s i n g 3 rd y e a r

4. Restraints Meaning Restraints in a medical setting are devices that limit a patient’s movement Definition Restraint is defined as ‘the intentional re s t r i c t i on of a p er s o n ’ s v o l un t a r y mo v eme n t or behaviour

5. General Principles For Use Of Restraints Should be selected to reduce clients movement only as much as necessary S h o u l d n o t i n t e r f ere w i t h t r e a t me n t Nurse should explain it.and reason for its use. S h o u l d b e ch a n g e d w h e n t h e y b e c om e s o i l ed S h o u l d b e r emo v e d e v e r y 2 h r s It should attach to bed frame not to side rails. S h o u l d b e a b l e t o q u i c k l y r e l e a s e t h e d e v i c e I t s h o u l d b e a w a y fro m c li e n t s r e a ch .

6. Types of Restraints Physical Restraints M e ch a n i c a l R e s t r a i n t s Ch e m i c a l or P h arm a c o l o g i c a l Restraints

7. Physical Restraints Physical restraint refers to means of purposely limiting or obstructing the freedom of a p e r s o n ’ s b o d ily mo v e m e n t . P h y s i c a l r e s t r a i n t s v e s t s , s t rap s / b e l t s , l i m b t i e s , w h e e l c h a i r ba r s a n d br a k e s , c h a i r s a nd b e d si d e ra i l s .

8. Mechanical Restraints Mechanical restraint is the restraint of a person by the application of a device to the person’s body, or a limb of the person, to restrict the person’s movement. Note It is used foí Extíemely Violent Patient’s .

9. Chemical or Pharmacological Restraints The intentional use of any medications to subdue, sedate, or restrain an individual. Drugs are ; Haloperidol, droperidol, risperidol, f l un i t r a z e pa m , midazolam, promethazine

10. Types of Physical Restraints MAMEE J M u m m y R e s t r a i n t s A bd om i n a l R e s t r a i n t Mittten or Finger Restraints E l b ow R e s t r a i n t s Extremity Restraints J a c k e t R e s t r a i n t s

11. 1 . Mum m y R e s t r a i n t s This may need to temporarily immobilize an i n fa n t or a y o u n g c h il d du r i n g a h e a l t h c a r e - related procedure to ensure his safety and t h e s ucc e s s of t h e p r o c e d u r e

12. 2 . A b d o m i n a l R e s t r a i n t s T h e a b d om i n a l c o n s t r a i n t d e v i c e w a s app li ed b e f o r e r e s u s c i t a t i o n, e n s u r i n g a s u i t a b l e a b d om i n a l compartment to contain hydropic organs and leaked fluid in a certain period of time

13. 3.Mitten or Fingertips Restraints The fingers are separated and cushioned. The mitt prevents contractures and keeps the c o n f u s ed pa t i e n t from t e a r i n g a t I V li n es or picking at wounds, yet still allows them to move about freely in bed.

14. 4.Elbow Restraints E l b ow re s t r a i n t s i s u s e d t o p re ve n t t h e i n fa n t f rom flexing his elbow so that he is unable to remove the n a s o g a s t r i c t u b e or s c a l p v e i n

15. 5.Extremity Restraints Limb restraints are soft, padded cuffs which are applied to a patient to prevent the patient from causing harm to themselves or to others.

16. 6.Jacket Restraints A jacket-shaped restraint that’s meant to c o n f i n e a v i o l e n t p er s on s a f e l y i s c a ll ed a s t r a i t j a c k e t . S t r a i t j a c k e t s w ere o n c e c ommo n l y u s ed i n p s y ch i a t r i c h o s p i t a l s .

17. Purposes of Restraints Restraints may be used to keep a person in proper position. Prevent movement or falling during surgery or while on a stretcher. Restraints can also be used to control or prevent harmful behavior. Sometimes hospital patients who are confused need restraints so that they do not do such things like Scratch their skin Remove catheters and tubes that give them medicine and fluids Get out of bed, fall, and hurt themselves Harm other people

18. Restraint Guidelines: Doctors order I n f o r med c o n s e n t Follow proper technique Least restrictive M a i n t a i n G ood b o d y a li g n me n t P a d b o n ey p r om i n e n c e

19. Side effects of Restraints P s y c h o l o g i c a l / E m o t i o n a l I nc re a s e d a g i t a t i on & h o s t ili t y F ee li n g s of h u m i li a t i o n , l o s s of d i g n i t y I nc re a s e d c o n f u s i on Fear

20. Physical: Pre s s u r e u l c er s , s k i n t r a u ma Decreased muscle mass,tone, strength, endurance R e d uc ed h e a r t a n d l un g c apa c i t y P h y s i c a l d i s c om f o r t , i nc r e a s ed pa i n I nc r e a s ed i nc o n t i n e n c e a n d u r i n a r y s t a s i s O b s t r uc t ed & r e s t r i c t ed c i r cu l a t i on R e d uc ed app e ti t e, D e h y d r a t i on Death

21. Nurses Role Monitor a patient in restraint every 15minutes for: Signs of injury Circulation &range of motion Comfort R e a d i n e s s f or d i s c o n t i n u a t i on of re s t r a i n t

22. Responsibility of Nurrse Assess the client’s behaviour & the need for restraint & apply it Get written order & obtain consent as per hospital policy Must communicates with client and family members Explain the client the reason for the restraint and cooperation Apply the least restrictive, reasonable and appropriate devices Arrange the client under restraint in a place for easy,, close & regular observation Attend the client’s biological & psychological needs during restraint at regular intervals. Document the use of restraint for record & inspection purpose

23. Conclusion Restraints were not associated with a significantly lower risk of falls or injuries in subgroups of residents likely to be restrained.

24. Thank you all