Skip to content
View in the app

A better way to browse. Learn more.
allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

Four point restraints

At 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?

Thank you!

  • Quote

    • Featured Replies

    Read your facility's policies carefully. Most places consider wrist and ankle restraints as 4-point. I am not sure about the bedrails.

    Best wishes!

  • Quote

    PLEASE 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

  • Quote

    That would depend on your facility.. All side rails up in my hospital is restrains and illegal so we can only do 3 to be "legal".. Sounds like a tricky situation.. I would go to your DON and ask.. In my state it is illegal in a LTC facility to restrain any of the residents.

  • Quote
    • Expert

    Restraints 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

    http://www.dads.state.tx.us/news_info/publications/brochures/restraints_guide.pdf

  • Quote

    The 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...

  • Quote

    I 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).

  • Quote

    • Join the conversation

    You can post now and register later. If you have an account, sign in now to post with your account.

    Guest
    Add a Comment
    Go to topic listing

    Currently Reading 0

    • No registered users viewing this page.

    Account

    Navigation

    Search

    Search

    Configure browser push notifications
    Chrome (Android)
    1. Tap the lock icon next to the address bar.
    2. Tap Permissions → Notifications.
    3. Adjust your preference.
    Chrome (Desktop)
    1. Click the padlock icon in the address bar.
    2. Select Site settings.
    3. Find Notifications and adjust your preference.