Are mittens a restraint at your facility?

[in2ICU]

Hi All,

Are mittens, used alone, considered a restraint at your facility?

I have worked at a couple of major magnet-designated medical centers and they have opposing views on classifying the use of mittens as a restraint. One says they are, and the other calls them a restraint alternative.

Just to be clear, I mean the boxing glove looking mittens that have velcro at the wrist to hold them on the patient's hands. These are NOT tied down in any way shape or form and the patient can still move his/her arms. Specifically, I use these in the ICU to keep patients who are sedated from pulling their ET tube or central line because obviously they are not thinking clearly!

Please let me know what your hospital's stance is... thanks!

[magnificentmel]

In my facility they are NOT considered a restraint is they are NOT tied to the bed. If they are they are considered a restraint, require a doctors order and RN documentation per our hospital policy.

[Girlygirl69]

Anything that restricts a person ability to move is a restraint. Mittens, socks, are defiantly restraints and need a docs order and the usual re-evaluations according to facility policy. Any place that says two mittens on at one time is not a restraint is playing a dangerous game.

Why do u say it's a dangerous game?

[tachybradyRN]

Anything that restricts a person ability to move is a restraint.

that's why they said that. and i agree.

[barbyann]

so are sequential compression devices restraints then?

[tyvin, BSN, RN]

Why do u say it's a dangerous game?

JCAHO, state surveyors, families looking for any excuse to file suits, the integrity of the patient themselves, etc... Facilities are often tagged with penalties for restraint violations.

The all time question of what constitutes a restraint has been going on forever. If surveyors suspect restraint abuse watch out. Facilities must have all their ducks in a row when it comes to restraints and doc orders and documentation specifically for restraint policy.

[poopprincess]

At my facility they are NOT a restraint because they are not tied down.

[Girlygirl69]

Okay I see. Thanks tyvin

[delilas]

Our floor (trauma) does not require an order to use them, but we do have to document when use starts and when use ends, as well as with each assessment.

[colnurse]

at my facility they are not a restraint, but are only used after we try many other methods like covers over their ivs. but we do have to chart their use and in my experience with mitts, they are easy to get off. my little old lady the other night took them off as quick as they were put on. and then another patient bit them open and then took them off and told us(nurses on the floor) if we put them on she would take them off. they are usually only used for the folks that pull ivs out, foley out, ngs, dobhoff, etc. i don't like to use them but if it keep sme from having to use real restraints I will do that anytime. and thankfully the other day, after my patient repeatly took off her mitts, i was able to talk her into leaving everything alone and was able to keep her safe.

[organichombre, ADN, BSN, MSN, LPN, RN]

At the Federal institution I work at we were told by administration that according to Joint Commission, mittens are in fact a restraint and needed to be documented as such.

[Nurse SMS, MSN, RN]

The LTAC hospital where I am doing clinicals uses them and they are considered a restraint, requiring orders q 24 hours.

[smartin13]

Mittens are considered restriaints in my facility if they are tied down. I work on a neuro floor and frequently we will put them on our patients without them being tied down. Many of our patients are able just to stick on hand under an arm and pull them off or shake them off, but some are unable to think in that manner and they work great for them. We don't need a MD order and because most rehabs in the area won't take patients who have been restrained for any reason it makes it easier to keep our access devices (that they won't have in rehab) safe while still being able to get the patient to rehab.