Four point restraints
- 0Jun 15, '11 by anastasia158At the LTAC Hospital I work at we can not put someone in a four point restraint.
1. If a patient has wrist restraints on their right and left arm AND the bottom side rails up - is that considered a four point restraint?
2. Is it appropriate for a patient to have wrist restraints and the upper two side rails up?
- 0Jun 15, '11 by demylenatedPLEASE read your policies. Even if this is not considered "four point," it is considered restraints because they can not get out of bed and mobility is obstructed (all 4 side rails are considered restraints). You MUST have a DOCTOR'S order and MUST follow them according to the order AND your facility/Ethics law... Otherwise you COULD be charged with false imprisonment.
We just happened to cover this today in class... LOL
- 0Jun 15, '11 by Esme12, BSN, RN Senior ModeratorRestraints are very individualized to each facility and policy and procedure. Four point restraint historically means all four limbs. Laws and standards of practice differ between LTC, LTAC, Acute care and psych facilities. Side rails are considered a form of restraint but are usually NOT included as a "four point" restraint.
Here is an example of the state of texas
- 0Jun 15, '11 by Whispera, BSN, MSN, APRN, CNSThe usual definition of four point restraints is restraining both wrists and both ankles. However, that doesn't mean you can restrain both wrists and put lower rails up as well. I can see someone maneuvering the lower half of the body over those side rails and getting into a great deal of discomfort.
Check your facility's policy...
- 0Jun 15, '11 by vampiregirlI work in a restraint free facility. We do have side rails however. We do an assessment upon admission to figure out what the side rails are being used for in each resident (safety, security, positioning etc). Then we obtain a doctor's order for them. I guess where I'm going with this, is first you have to figure out what the side rails are being used for.
Another thing to consider, is if the resident can climb over the side rails (especially confused residents). So, I would be very hesitant to use side rails as a restraint. It is a greater risk for some residents to have them up (another option being a low bed w/ floor padding).