The Utilization and Application of Restraints in Non-psychiatric Patients

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

4) Significance: This research shows that there is a gap in the evidence, but that the primary concern for nursing staff is to ensure that catheters are removed as soon as it is possible to do so.

The nurse driven protocol was tested in 4 intensive care units. It included evidence-based orders for discontinuing, handling, and properly managing the catheters. One of the most important factors was the removal of the catheters in a timely manner. The data pre

I recommend everyone using physical techniques of any kind be trained on the risks of positional asphyxiation. Whenever, I physically restrict a person’s movement there is a risk of injury, and no physical holds are 100% safe. In this book, I cover body positioning for physical interventions, standing holds, and seated holds. I do not authorize or encourage a prone restraint without the proper training; and this type of restraint is not covered in this book. However, the SafeClinch Training System does allow for “prone containment” for those organizations allowed to use it; once SafeClinch instructor certification has been achieved. Here is an example of what the prone position looks like. Notice, since the person is in the prone position

Mother Behind Bars examines a lot of inadequate policies and procedures that these states have in place for federal and state correctional facilities. This report card bring up the issue on prenatal care, shackling, prison nurseries, and family based treatment as an alternative to incarceration however in this paper I will focus on the restraints on these pregnant inmates. New Jersey received a grade of D for shackling policies. Besides New Jersey thirty-seven other states obtain a D/F for their failure to comprehensively limit, or limit at all, the use of restraints on pregnant women transportation, labor, delivery, and postpartum recuperation (National Women’s Law Center, 2010). The use of restraints can compromise the health and safety of the women and the unborn child. Shackling pregnant women is dangerous and inhumane; women prisoners are still routinely shackled during pregnancy and childbirth. The reason these women are shackled is for safety and security, despite the fact that shackling pregnant women is degrading, unnecessary and a violation of human rights some state still condone this practice.

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.

The nursing supervisor has multiple issues to address in this scenario, the use of restraints and formation of a pressure ulcer are of a great concern, but I believe these are easily rectified with training and follow-up audits to ensure

There are a few ethical issues that in the provided scenario which need addressing from the nursing shift supervisor. The first occurs when the Certified Nursing Assistant (CNA) fails to appropriately address the possibility of a developing pressure ulcer. A wound care team can be consulted about developing an educational program about pressure ulcers for hospital staff. Also, there is the issue of restraints. The ordering physician should be contacted about the necessity of restraint use. Along with the wound care team, data could be collected about the use of restraints and the subsequent development of

All patients are at risk of pressure injuries. This risk is exacerbated when immobility and limited access to the surgically draped patient are a part of

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.

That being stated, if a patient must be placed on restraints, qualified professionals must have a comprehensive understanding of patient outcomes that correspond with the use of restraints. First and foremost, skin integrity is placed at risk if proper placement and management of patient care while in restraints is not implemented as with the case of Mr. J. There is numerous evidence based research studies conducted that correlate the use of restrains with an increase in pressure ulcers (Baumgarten, Margolis, Localio, Kagan, Lowe, Kinosian, Abbuhi & Abbuhi, 2010).

Not only are you restricted from you family, you can not do things on your own, you will always need assistance. You will need assistance to eat, drink, or even itch your nose. You will need help performing any activities that require you to sit up or use your hands in any way. This experience is not a reward, in most cases the restraints are used as a punishment. If the patient is not cooperating, being violent or self destructive to the degree of where they are jeopardizing their physical health, they may be put in the soft limb restraints. There are many behavior requirements that will result in the use of the soft limb restraints, such as hitting, kicking, pushing, trying to remove their IV line, or other medical requirements, or even trying to leave the hospital room. The soft limb restraints are used to protect the patient. Although they are used for the better of the patient, I would not enjoy being tied down to a bed, I would feel unwanted, or even chained

WEEK 5 PICO(T) QUESTION 1Good Afternoon Class and Dr. Stephenson,In and out of the hospital high quality cardiopulmonary resuscitation (CPR) is crucial to survival of victims of cardiac arrest. This research topic will focus on implementation of in hospital chest compressions in CPR. It will be based on a comparison of the efficacy of manual compressions and automated chest compressions in relation to survival outcomes. The potential attributes and short comings related to manual and automated chest compression will be reviewed. Intensive care unit (ICU) nurses have to be prepared to implement CPR during a cardiac arrest code. In consideration that patients in the ICU are often only marginally stable it is important that ICU nurses are familiar with their patient’s recent and past medical histories.

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.

It is appreciated that the given case study contains other factors such as psychological trauma and the impact of blood loss. However this essay is going to explore the efficacy of pre hospital immobilisation utilising cervical collars and extrication/ orthopaedic stretchers, reflecting on an account from the paramedic’s practice. A modified framework of Gibbs Reflective cycle (1988) will be used. Including Description, Feelings, Evaluation, Conclusion and Action Plan. This essay is supported throughout using relevant evidence and seminal work.