Ok, so I'm definitely unsure of the state/federal laws on using restraints for intubated patients that are used solely to prevent a patient from pulling out their ET tube. I regularly place soft wrist restraints on my intubated patients. Often we have to adjust their sedation and I once had a patient pull out her tube, so I'm very cautious.
There's an educator where I work whose specialty is geriatric psych, so I'm not sure she knows how the law/rules apply for our specific population/environment, since this type of restraint is different. She states we need an order.
I haven't been able to find the specific laws on this topic. I have been looking for resources to be able to check my own nursing practice. I'm sure I'll be called out again for this by this educator, so I just want to be sure that what I'm doing is not just "how we've done it," or is there validity to what I have been doing.
I also do not regularly see orders for an ICU patient that has "soft wrist restraints" as an order to protect ET tube.
Ideas? Thoughts? Resources?
Jun 9, '12
by MassED, BSN
Quote from Mini-Murse
I'm incredulous. You work in an ICU and you don't know the laws and your hospital policy on restraints? Needing an order for ANY restraint is the first thing they teach you in your Ethics section of Nursing Fundamentals I.
I really hope none of my family members are ever patients of yours - I don't want their nurse to be making up his or her own rules about restraints, treatment, etc.
I honestly recommend going back and taking some CE on ethics, ICU, and restraints ASAP.
No, I don't work ICU. I work ER. I don't know how long you've been a nurse, but laws/rules, as well as individual hospital regulations differ. Certainly over the years. This isn't about being "incredulous" or posting anything negative, it's about finding out the specific resources for restraints, federal/state. I'm specifically referencing the use of restraints for an intubated patient to prevent pulling of the ET tube. I'm not discussing all other aspects of restraint use/documentation/and orders.
Also, a few other nurses that I work with, who have been in the ER for 20 + years were also scratching their heads, unsure as well. We have always used them, just as we have used the side rails to be up on a comatose, confused, or intubated patient. When I worked med/surg, restraints up all the way around were considered restraints, but that doesn't apply to the ER, so I'm sure you can see where I'm coming from now.
I'm sure ICU does have their standing orders, but since I don't work there, I can't speak to that.
Last edit by MassED on Jun 9, '12