Restraint Free or Not

[I2AMARN]

I am putting the question out for practice on restraint free or not. Our hospital has just decided to go restraint free with the exception of the CCU/ICU and behavioral health. I am just curious if this is the practice of other facilities as well and how it is working out for you.

Thanks!

[Tweety, BSN, RN]

There was a death-by-restraints incident in our facility (not my unit) and our manager decided to go restraint free. We had to increase our use of sitters and bed alarms, but we have too many head injured patients pulling out trachs and tubes and it wasn't really safe. It lasted almost six months, so it can be done. We restrain now as a last resort.

Good luck.

[Altra, BSN, RN]

My first thought: for the coked-up or psychotic patient brought to the ER in handcuffs, the time for possible diffusion & de-escalation has long since passed. Restraint-free? To what end? To give those patients who by virtue of their intoxication, altered mental status or other impairment the ability to harm themselves and/or staff?

[ICRN2008, BSN, RN]

I have only seen restraints used once in seven months of peds practice. We make extensive use of sitters at my facility.

[burn out]

My hospital has been restraint free for over a year (I thought it was now a JACAHO standard now). It has not been bad in fact I think it is better in our ICU. We no longer have restraints on ventilated patients..until we are waking them up to extubate. As for our psychotic patients it is easier to keep them in bed now then them fighting the restraints. I don't think we have had one fall on the unit in the last year.

[SarahRNBSN]

My facility uses restraints (as a last resort of course) and with some of these patients, I can't imagine what would happen if we were restraint free. Just out of curiousity, at the restraint free facilities, how do you deal with the combative patients who are kicking/punching/slapping/etc. the sitters, family or staff? :uhoh21: I just don't feel anyone's safety should be compromised, that's all. As much as I hate using restraints, I'm glad we are allowed to in some cases.

[RNperdiem, RN]

My hospital is not restraint free. Restraint paperwork is more cumbersome, but most of our patients are on ventilators. Many, when first admitted are wild and pulling lines. If I was standing before the judge after a patient harmed themself, would the hospital support me? Would JHACO back me up?