Alternatives To Restraining Children

Hospital data on the use of restraint can also be analyzed to improve patient outcomes and satisfaction. This information could be scrutinized to determine if restraints were truly warranted in that particular situation, or if another method could have or should have been utilized first. Documentation should also be examined to determine if the patient was adequately cared for during this time period. In my hospital, the patient must be released from the restraints at least every two hours, and must be toileted at that time. The nurse must also do range of motion exercises with the extremities affected by the restraints. The skin and circulation should be assessed at this time. Every hour, the nurse is required to check the pulses in the extremity affected by the restraint. The nurse’s documentation should reflect that all of these assessments were performed and the appropriate precautions were taken.

The nurse supposed to be aware of time consuming techniques and avoid those in emergency cases. For example, techniques that takes a long time, such sitting next to the patient and listening to the patient’s concerns must be avoided in emergency situations, instead the nurse can make eye contact with the patient and reassure him or her that everything will be done for the patient. Therapeutic communication must be used for all patients regardless of their ethnicity, race, age, sex, and religion. All nurses must apply these techniques in practice for all their patients in the same manner. Mostly all therapeutic techniques are under nursing scope of practice due to the reason that they are done psychologically and there is no specific use of medications, physical tasks, or decision making involved. Therefore, all nurses can apply these techniques freely since they are all under the scope of practice. Nurses must be aware of external and internal regulations while using therapeutic communication techniques. Sometimes, the techniques take time to be done and nurses must make sure they will do all other tasks that the organization assigned to them on-time. Potential breakdowns in these areas can be the low amount of time to apply the techniques at bed-side or in emergency situation. Nurses have multiple patients and multiple tasks to perform at all times and applying

J’s scenario is pressure ulcer. From analyzing Mr. J’s case one can see the correlation between the use of restraints and pressure ulcers. Obtaining data listed on the Braden Scale such as moisture, mobility, activity, and nutrition are important when assessing for pressure ulcer risks. Once the collected data indicates the patient is high risk then the established pressure ulcer protocol needs to be followed. Nurses will need to minimize friction, support bony surfaces, manage moisture, and maintain adequate nutrition to advance quality patient care. The other nursing-sensitive indicator in this case is restraints. As I have mentioned earlier the use of restraints in Mr. J’s case seems appropriate as he pose great fall risk which may further complicate his current health condition. However, it is important to perform a complete assessment on the parameters for restraint such as cognitive functioning, history of dementia, physical impairment, and drug interactions to determine the need for restraints. When restraint is clinically indicated, and the benefits outweigh the risks then protocol for restraints has to be followed. Once the patient is restrained, it is standard practice that restraints are to be removed as soon as possible, and the patient in restraints will need assistance to change position every two hours. B) To improve quality patient care throughout the hospital, the quality improvement department should scrutinize, and keep track of the

The key aspects of this skill are consent, preparation and prevention. The nurse must obtain consent from the patient and explain the procedure. The patient must be made comfortable and placed in a suitable position

The focus of the visit for the patients was to promote wellness and an annual examination. These examinations consisted of healthcare professionals ensuring proper health status, growth, can development of the child. Healthcare professionals promoted patient participation through the patient’s involvement in their care. During the wellness visit for each patient, the child was acknowledged and was asked about their feelings regarding their health. Additionally, an example of participation involved the child holding the stethoscope on their chest while the physician listened to heart and lung sounds. Non-pharmacologic modalities that were implemented for the patients involved the use of educational health materials such as books to read and the use of toys during procedures. These non-pharmacologic materials were implemented in this healthcare setting for educational and comfort

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.

It is important that it is recognised where treatment could be improved and enhanced in order to increase quality of care and ensure patient safety and security. It is also important that it is understood that a more efficient approach would have benefitted the situation and the relationship with the patient significantly. Taking into consideration the age and the emotional state of the child while acting

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,

She made sure that the patient’s belongings were gathered and placed in a bag for easy access when he was finished with his surgery. She confirmed that the patient had nothing to eat or drink that morning and showered twice with specific antibacterial soap. She signed as a witness on the consent form stating that the patient voluntarily signed the form. She completed an assessment for a baseline to compare when he would be in the recovery room. In addition, the nurse determined that the preoperative checklist was completed and all prescribed medication was given before the patient proceeded back for the operation. The nurses in the intraoperative phase were more concerned for the patient’s safety during surgery. They stressed the importance of me keeping a foot away from the sterile field at all times and ensured that the patient’s limbs were secured in place. An important patient care detail that occurred was the count of items utilized during the operation. The scrub and circulating nurse counted each piece that was used and made sure that everything was accounted for. In the postoperative phase, the nurses were primarily focused on the safety and orientation of the patient. The recovery nurses assessed if the patient was able to smile symmetrically, stick out his tongue, bilaterally squeeze with his hands, and perform plantar and dorsal flexion of his feet. They evaluated the pupils to ensure they reacted to light and assessed the vital signs closing to any

Each patient entering the procedure may have different expectations about the outcome of the procedure, but there is little evidence supporting patient expectation and patient satisfaction. However, the specialist nurse is a key role in this, and they can set realistic and achievable goals for the patient at each step along the process. The aim of this experiment was to ensure that the patient understands that a decision will be reached that will reflect the specialist team’s views as to the best interests of the individual patient (Frame 2015).

I strongly believe physical restraints are used to increase the patient’s safety but often has an effect opposite of the intended purpose, which is to protect the patient from injury. Under the review of literature that I have gone through, in my opinion restraints should be used according to the Least Restraint Policy ( J. Williams et al, 2010). The first rule as a nurse is to understand your patient that you are taking care and only then you will be able to figure out the reasons for a patients behaviour and can act accordingly by taking into account the alternative measures. As nurses we should consider the risk of using a restraint and must use our clinical judgment and decision making power to make the best choice for the patient.

The use of physical restraint is quite common among caregivers in health facilities when dealing with geriatric patients. Yet this topic is one of the most debated issues in healthcare and medicine. The purpose of medical restraints is to prevent patients from harming themselves or those around them. It seems to be a simple solution and panacea for unruly patients who needs to be treated. However, ethical implications surround its usage as the practice of physically restricting people strips them of their autonomy as well as other psychological factors, such as agitation and trauma. Therein lies the dilemma on how to approach such an issue.

I think you identified good areas in the hospital that could support your concerns of the recent increase in the use of physical restraints as well as the use of sedating medications. Patient safety is always our priority whether we are a bedside nurse or family nurse practitioner. The most up-to-date evidence-based research should remain in continuous efforts to identify the safest and most effective means of restraints. This can be achieved through the case-control study you mentioned in your post. In addition to the information you provided about this specific study design, Curley and Vitale (2016), identifies both its strengths and weakesses. Strengths of the case-control study design include, "inexpensive, shorter time to completion,

Residents who are restricted, or confined, or has lack of control, tend to be confused, very irrational, in a psychosis state of mind it is due to some form of restraint. Restraints are oftentimes used during a period when a person is of danger to themselves or others around them. Restraints should never be used for convenience of staff caring for the patient not even as a substitute for nursing care (National Executive Training Institute (NETI), 2005). Systematically, assessments are completed when determining the type of physical restraint that is required contingent on the state or level of confusion that a person may be in. Whether it is through objective observation or if the behavior that is being exhibited can be identified whether it

The more painful tests, the less trust of me as a nurse caring of the child, so I think that one of my important roles as a pediatric nurse is to improve a palliative touch and find traumatic devises to make the treating and caring process as easier, safer as possible. In my master course of pediatrics clinical experience, I learn how to be alert about every small content of the child and mother environment that may affect their safety, so even improving the parents to be with child most of the time is one of the most important implementation of a traumatic care, I think I must be fully conscious of applying side riles of the bed of the child most of the time, to chose the suitable needle size and gauge to reduce pain, checking the child for sensitivity to any type of latex, plaster ,chemical solution, to prevent skin or respiratory irritation, I believed on mother education about checking the bathing water before applying it, and choosing the cotton non-irritating not tying, with less ribbons clothing, in addition to the safe precautions for preventing transmission of infection through milk bottles or pacifiers ,or direct exposed to infected persons, I am sure that hygienic practice education to the mother will help