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Discussion

Elbow Splints, Restraints?

I take care of a lot of post-op cleft lip/palate kids and post-op protocol is to have elbow splints on. No MD order is needed q24h for the splints. Well another nurse said they were restraints while she was auditing charts. We got to talking about this and could not find any policy on this issue, are they restraints and do children need the q2h restraint check documented?

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We use them too. We have never thought of them as restraints. We don't document them as restraints.

I guess this is a good question.

We do document them as restraints. Even though they are used to hold IV's in place, or prevent drains/tubes from being pulled, its considered a restraint.

I dont know if we have a policy on it, but I was told on orientation they were restraints. I do take them off every few hours and do circ. checks to make sure they arent too tight.

However, I guess in your situation where its part of your post op protocol, it may not be considered a restraint..

may not be a restraint in the legal sense, certainly is in the physical sense and SHOULD be checked on the same or more frequent schedule....and leaving them off when doing hands on care, so the infant has some freedom is a thought as well

I'm sure JCAHO would view them as restraints. A number of years ago, JCAHO told us that arm boards on neonatal IVs were considered restraints. Based on that tidbit, I'm sure elbow splints would be considered restraints as well. Be sure to document as such.

We use elbow restraints because they are not restraints according to jcaho.

They are considered restraints at our hospital, and we have to have a new order from the physician every 24 hours in order to keep using them. We only use them if absolutely necessary, though.

We use these "restraints" on nearly all of your young pediatric population, and we are not required to get any type of order from the MD.

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I work at a large, stand-alone pediatric teaching hospital and we use them frequently for our cleft lip/palate kids as well as others, and we are required to get an MD order q24h as well as circ checks q2h.

We consider them restraints. Which I hate, because I preferred them to taping the kid to an armboard. And think it's silly I can tape a kid's arm straight and on a board to where it will take 5 minutes to get it free, but can't put them in a nice velcro thing that's easily removed by staff and does a much nicer job of protecting the site. But I don't want to whine too much, or they'll take our armboards away too.:banghead:

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