Restraints - Page 3

It sounds a frustrating situation.

It was always my understanding that a mitt wasn't considered a restraint unless it was tied to the bed/chair/etc.

I would like to restrain "No restraint policies."

And apply haldol/ativan/benadryl liberally :-)

Mitts are very definitely a restraint. I have set up an a so that I refuse all restraints for any purpose. If that means not having life saving treatment - so be it.

Horrible solution, sounds like an ethics consult should be contacted

I think whether mitts are considered a restraint varies by facility. Previously, they were not considered a restraint at my hospital (which I always found odd). Recently, policy has changed and now mitts are going to be considered a restraint (duh).

Mittens are one of those gray areas where some facilities consider them a restraint and some don't. I personally think they shouldn't be a restraint because free movement is not compromised--they can move the wrist, hand, and fingers-- but they prevent grabbing vents and lines. Seems like a humane, logical intervention to me, but whoever said government regulations were humane and logical?

Chemical restraint ...

Oh RLY? some of you get way to worked up about all this, but you ask questions and you get answers. I had a pt with AMS who would rip off anything attached or inserted, bad sun downer, anyway... I wrapped his hands in kerlix to protects him from causing damage to himself, ie... pulling out a fully inflated catheter, pulling out his CVA... risk for infection. initiate a nursing order, wrap lightly around the wrist begin your fold at the volar aspect of his wrist, over the palm, twist over in between the 1st and 2nd digit, continue over the palm, wrap over the top and secure his thumb to his fore finger, and document. he wasnt at risk for breakdown, he had great circulation in his extremities, and when I did my q2 and 4 reassessments, I documented to that effect. he still pawed at his accouterments but was unable to grasp them and all was well...

and really you have a pt on vent who isnt sedated enough to prevent this? that would make me concerned and uncomfortable. how is it that your "boss" determines what care the patient does and doesnt get? ultimately it's the physicians responsibility to call it... speak up for whats right, you know how to do this, who ever the determining authority is, describe the Situation, provide the Background, Give your Assessment, and Recommendation. SBAR... if you fail to be heard twice and you still feel strongly, don;t let it die there, that how mistakes and errors occur. these incidences are preventable, why do we have to wait until something happens to enact change? but as always hindsight bias is 20/20...

Sounds to me like there should either be a change in policy from the totalitarian stance of "no restraint facility", OR, you should't have patients, who require the intervention, present in your facility, and requires a greater level of care.

Good luck, I hope your patient benefits from your persistence.