Restraint and Seclusion: Helpful or Harmful?
Southern Illinois University at Carbondale
Abstract
Students with severe mental health issues or developmental disorders display problem behaviors that put themselves and/or others at risk of injury. In these cases should restrictive interventions such as restraint or seclusion be implemented? The prevalence rate of these behaviors among students with developmental disabilities has been reported to range from 2-28% for aggression and 10-31% for self-injury (Borthwick-Duffy, 1994). When all less restrictive interventions have failed and students are at risk of injuring themselves or others can we justify restrictive treatment method? Restrictive treatment methods such as restraint
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Physical restraint involves using physical force to immobilize the child or prevent them from having freedom of movement. Physical restraint is also referred to as ambulatory restraint, manual restraint or therapeutic holding (American Academy of Pediatrics Committee on Pediatric Emergency Medicine, 1997). This method prevents the child from freely moving their arms, legs, head or torso. Physical restraint can also include holding one component of a child (the wrist) for a brief period of time to interrupt or stop a behavior from happening such as picking or hitting. Council for Exceptional Children defines physical restraint as any method where one or more persons restrict another person’s freedom of movement, physical activity, or normal access to his or her body (CEC, 2009). It is a means for controlling that person’s movement, obtaining behavioral control, and establishing and maintaining safety for the out-of-control individual, other individuals, and staff. Physical restraints have been in widespread use across most human service, medical, juvenile justice, and education programs for a long period of time. Physical restraint of patients began in France in the late 18th century and later developed by Philippe Pinel & Jean Baptiste Pussin to prevent patients from injuring themselves or others (Fisher, 1994). Physical restraints have been used with emotionally disturbed children in the US since the …show more content…
The problems related to the use of restraint and seclusion have been categorized into five main areas. These areas include risks of physically and psychologically harm, lack of behavior change procedures taught, disparity, discrimination and lack of compliance with IDEA standards. The first area is that they carry a risk of someone being hurt, either the child or the adult. There are recorded instances where children have died from these procedures. There is also a risk of psychological problems including trauma. Recurrent use of these procedures carries a risk that the child’s development of safe and secure relationships with adults can be impaired. These procedures are highly problematic as interventions for controlling these challenging behaviors because they have been associated with an alarming amount of abuse and physical and psychological injury to children. (Dunlap et al). Much of the focus of the harmful effects of restraint includes a focus on the problems associated with the improper use of these procedures resulting in serious injuries and sometime death. A well-known report by The Hartford Courant estimated that there were 142 restraint related deaths in the United States between 1988-1998 (Weiss, 1998). This figure
A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages from restraining could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). Educating nurses may reduce restraint usage by increasing
Background Information: A physical restraint can be defined as “any manual method or physical/mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot
Restraints is an intervention used to confine a person to prevent injury to self or others. Different types of restraints include physical, chemical and seclusion. A physical restraint is anything that prevents the patient from being able to freely move. This can include seat belts, wrist restraints, vests, bed rails, etc. A chemical restraint is using a drug for sedation which also restricts movement or freedom. An example of a chemical restraint can be an antipsychotic. These drugs can be used to reduce anxiety, aggression, and violent behavior. Lastly, seclusion is isolating or confining the patient to a room where they cannot leave. This form of restraint is also to protect the patient from harming them self or others. The use of restraints or seclusion can be a useful intervention if all other interventions have failed. Patients should not be harmed with these restraints so it is crucial they are done properly. Patients who are put in restraints
•There was an extremely high rate of ‘physical intervention’, well over 500 reported cases of restraint in a fifteen month
Deveau and Leitch challenge the idea of restraints being positive for a pediatric mental health setting. “Restraining children may lead to physical and mental harm for children subject to such practices” (Deveau, Leitch, 2014, p. 588). Presented earlier was the idea that restraints used on a pediatric patient should ultimately be beneficial to the patient and those within the patient’s environment. Unfortunately, that may not always be the case. Like other nursing interventions, risk factors are also associated with restraints. Deveau and Leitch’s performed a studied and gathered that within the United States of America there were 142 restraint-related deaths within a one-year time span (2014, p. 588). Blood clots, restricted breathing and blunt trauma, abrasions and bruising may also be associated with risk factors that may occur during physical interventions
The article involves the use of restraining techniques (handcuffs) on children with ADHD (Attention Deficit Hyperactivity Disorder) by police officers. The incident occurred recently, a Kentucky sheriff was videotaped handcuffing an 8 years old child at the elbow because the child wrist was too small to fit the handcuff. According to the news article, this is not the first time a child with ADHD is being subjected to this type of treatment, the same police officer that was involved in this incident has been accused of unlawfully restraining an 8 years boy and a 9 years old girl, both child also suffered from ADHD and apparently, it is a common practice for police officers to use restrain on children who are deemed out of control due to ADHD
Restraints limit a patient’s movement. This brings up many ethical debates and issues. There are certain guidelines that should be followed when it comes to using restraints. It is important to know the different kinds of restraints, how to apply a physical restraint properly and how to administer a chemical restraint safely. It is important to consider alternatives as the use of restraints can present risk and negative outcomes.
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.
A passive restraint device is very important for any driver whether they are advanced or a beginner. They can save you in the time of a car crash, giving you and others in the car a chance to survive. Although, you can still be injured from the collision since the air bag will burst from the wheel to cushion the impact. You can prevent from using it by following basic driving laws, and staying aware of your
Many people today are getting arrested for simply disciplining a child. But, in older times disciplining a child set good moral standards and taught that child on what that child was supposed to do and what not to do. There is a fine line between abuse and discipline. So what is child abuse? Child abuse consists of any act of commission or omission that endangers or impairs a child’s physical or emotional health and development. Child abuse includes any damage done to a child which cannot be reasonably explained and which is often represented by an injury or series of injuries appearing to be non-accidental in nature. There are also different kinds of child abuse; which include physical, emotional, and sexual. But, discipline does not
Many studies have come out with negative effects that can come about from using many forms of corporal punishment. As parents we need to ask ourselves are we able to control ourselves when we are upset at our kids? Are we able to be fair to our kids? Can the things we do to our children come back and turn out to be used against us and others? “Corporal punishment
Behavioral principles have long been employed to achieve educational progress with children who have intellectual disabilities (Drew & Hardman, 2007). An issue of substantial concern is behaviors that may be self-injurious or dangerous to those surrounding the individual. In order to prevent occurrences of inappropriate behavior, family members and the educational staff must put effective interventions into place. These behavior procedures include the use of punishment and aversive consequences, and are sometimes put forth by professionals to change inappropriate behavior (Drew & Hardman, 2007). However, controversy exists over the social and ethical issues involved with the implementation of aversive procedures, especially when working with young children.
Children are like flowers, if well taken care of they will bloom. If ignored or tortured, they will wither and die. Child discipline is one of the most important elements of successful parenting. Today, many people have this notion that physical abuse is in no way a solution to helping children discern between right and wrong. Since generations children have been taught the art of discipline through physical punishment. Often this approach to disciplining has resulted in two outcomes, one is where the child becomes more tolerant and is willing to adhere to what he/she has been told, or the other which more often results in children developing a sense of anguish and desire to revolt.
For many years parents have been disciplining their children in various ways. Discipline is required to train a child in doing what is right and staying away from what is wrong and dangerous. Discipline has always been used in order for the child not to grow up spoiled and choosy. Giving children what they want always is never a good thing, while teaching them that they cannot have everything teaches them patience. Discipline is very critical in a child’s life because it is a determining factor on how that child is going to turn out in the future. People will always relate bad parenting to a child’s bad behaviour and good parenting to a good behaviour. So how must parents discipline in order
Skokie is a small village in Illinois, where many survivors of the holocaust lived together in peace. One day a group of neo-Nazis, decided they wanted to match in the town of Skokie, wearing swastika, and matching in in Nazi uniforms. The people of Skokie went to court to stop these individuals from spreading their hateful message against the Jews. Prior Restraint came into play when the Supreme Court stopped an injunction against the Neo-Nazi group. Prior Restraint is used to stop speech before it is used. The Supreme Court of both Illinois and the U.S. decided that the march was allowed to take place because it did not go against the constitution.