A restraint is any physical or chemical measure in the healthcare setting to keep a patient from

As health care workers we are under a legal obligation to protect an individual from any kind of abuse, whether it is physical, financial, emotional, sexual or psychological .Legislation, policies and procedures exist to promote a safer working environment and reduce the potential for risks occurring. They are tailored for the needs of each setting, known and understood by employers and employees and reviewed on a regular basis.

The use of less lethal weapons that are approved by TDCJ are by using restraints, protective equipment, chemical agents, and less than lethal ammunition. The restraints are defined as a measure or condition that keeps someone or something under control or within limits. Restraints in corrections system are used to escort offenders from place to place and controlling the offenders. The restraints that are approved by TDCJ are hand and leg restraint cuffs and a belt restraint. The officer puts on the hand and leg restraint cuffs which are a pair of lockable linked metal rings hooked together with a chain that is approximately four inches long for hands and twelve inches long for legs. Then belt restraint are used as a strong wrap around the offenders waist that has chains that connect the hand and leg restraint cuffs to the belt restraint. These restraints together keep the offender from having full mobility. Which according to most studies, it has helped prevent attacks on officers (Smith,R.2009). The use of protective equipment such as riot helmets, riot shields, riot batons, and stab vest. These protective equipment are mainly used when an offender or offenders are causing a violent public disturbance, or riot; it was to calm the violent offenders, yet protect the officers from being injured or killed. By having the riot helmets, shields, and batons helps

Any of these issues have the potential to extend the patients length of stay in the hospital. The restraints have the potential to make the patient more agitated, thus increasing his risk of injury. Understanding the nursing-sensitive indicators can greatly contribute to a better outcome for all patients.

Restraints prevalence is another NIS that could assist the nurses in the above scenario to identify

The following section provides a review of the literature on the use of physical and chemical restraints in long-term care settings as well as potential institutional-level and resident-level factors that influence care practices in long-term care settings.

Despite these “rights” nurses in the United States and around the world still use restraints stating the main reason is for patient safety.

The purpose of this paper is to critique the research article, Mohler & Meyer’s “Attitude of nurses towards the use of restraints in geriatric care: A systemic review of qualitative and quantitative study 2014. The incident I am going to discuss in this paper is of Mr. P., an 85-year-old man, admitted to this facility about 4 months ago. His history includes coronary heart disease, cataract, dementia, hypertension, macular degeneration and Alzheimer’s. Mr P. scored 28 of 30 on the Folstein Mini-Mental State Test, he missed the date and recalled 2 of 3 objects in 5 minutes (Folstein, Folstein, and McHugh 1973). His medications include; Analgesics, antihypertensions, antipsychotics

Physical/manual restraint by a team, mechanical restraint and seclusion should only be used for people detained in a mental health facility under the NSW Mental Health Act 2007 or the Mental Health (Forensic Provisions) Act 1990. If one of these interventions is applied to a voluntary patient, a Medical Officer (M.O.) must assess them as soon as possible after the event to review their status under the Mental Health Act.

Admissions in general acute hospitals for patients over the age of 65 is 38% with 60% of those patients ending up on a medical surgical unit (Boltz, 2013). The number of restrained patients within this age range varies from 13-27% for medical surgical or non behavioral restraints, this number can significantly decrease based on alternative interventions attempted prior to restraint application with the number of restrained days varying from 3 to 123 out of every 1000 days (Enns et al., 2014). Reasons for non behavioral restraints are when a patient is; pulling at lines/tubes, removal of equipment/dressing, inability to respond to direct requests/follow instructions, intubation, or falls/risk of injury/keeping patients safe. A typical hospital

The General Accounting Office and the Health Human Services Office of Inspector General both have noted the lack of known data related to the use of these practices (Joint Commission on the Accreditation of Healthcare Organization [JCAHO], 2004). Research has revealed that the use of restraints varies dramatically from facility to facility with a wide range of facility and staff knowledge on how to prevent and avoid such use. According to Castle and Mor (1998), there are a growing number of stakeholders that have developed guidelines for restraints use and the quality of these guidelines have yet to be determined and their widespread application

American Nurses Association started the Handle with Care Campaign in 2003; American Nurses Association published Safe Patient Handling and Mobility guidelines in 2013

Restraints use has become a legal issue as individual rights have become paramount in society. The United States was the first country to implement federal restraint standards in 1984 (U.S. Department of Health and Human Services, 1984). The UK, on the other hand, does not accept physical restraint use at all, but it is a common practice in the US, Australia, and mainland Europe (Maccioli, Dorman, & Brown, 2003; Royal College of Nursing, 2004; Van Norman & Palmer,

Falls and physical restraint use are a common practice in the care of the elderly and many efforts have been made to decrease this practice. Falls and injuries associated with restraint usage are a major issue because of their adverse outcome on mortality and morbidity. Prevention of falls and injuries is the most common reason for mechanically or physically restraining the elderly in healthcare facilities (Arbesman & Wright, 1999). Its use has, conversely, been examined both from an ethical perspective, since restraints can be observed as coercive and furthermore because of the absence of proof of their effectiveness in preventing falls, as well as the adverse effects associated with their use (Capezuti et al., 1989). The main purposes of this integrative review were to investigate differences in the use of physical restraints over time, to identify risk factors for falls among people 60 and older, to evaluate the effects of a restraint program on staff awareness, work environment and practice of physical/mechanical restraints and the quality of care.

While the use of physical restraint on elderly patients is necessary in specific situations, the practice should be very limited at all times. Although it will continue to be used worldwide, measures must be taken by all healthcare providers to gradually minimize the use of restraints in healthcare facilities, reduce the risks that are associated with the practice, offer reasonable alternatives for patient care, and ensure the safety of the patients as well as their caregivers.

Wide variation in the duration of mechanical restraint episodes was reported between countries. For example, the mean duration of restraint in German psychiatric hospitals was found to be 10 hours compared to 49 hours in Switzerland (Martin et al. 2007). In