Restraint question

[lucy8686]

At my last facility, if a patient ended up in 4 point restraints for violent behaviors, we would release one arm and opposite leg to “trial” how the patient responded before removing all restraints. At this new facility, it says if you go from 4 limbs restrained down to 2 limbs restrained, you need a new order.

How is it done where you are?

[psychnurse2242]

I have seen both ways, but never have heard of it needing a new order if you release one or two at a time. At my current facility we just release all 4 at once. Maybe your facility has a policy on it, or should specify if not. The issue I could see that would cause you to need a new order would be if you have to re-apply the arm and the leg if the patient "fails" the trial, which could be seen as re-initiating restraints.

Technically, if the patient is calm enough that you feel comfortable releasing two restraints, why not all four, since they would be able to remove the other two if they wanted.

[hppygr8ful, ASN, RN, EMT-I]

6 hours ago, psychnurse2242 said:

Technically, if the patient is calm enough that you feel comfortable releasing two restraints, why not all four, since they would be able to remove the other two if they wanted.

Our leather restraints have locks on them that require keys so they can't take them off even with a hand or leg free.

As to the OP's question - I think there is more of a facility policy question. We often let hand free if the patient wants to eat, scratch their nose etc. but a person in restraints has a 1:1 staff with them at all times.

Hppy

[Meriwhen, ASN, BSN, MSN, RN]

Our facility policy is that we can't "trial" release from restraints. If a patient meets criteria for release from restraints, then they are to be released, though for safety reasons the restraints are undone one limb at a time. Should the patient start acting out during release to the point that they require re-restraint, that would call for a new restraint order.

But at our facility, we are allowed to put a patient in restraints provided we call the MD as soon as possible to get the restraint order. So should the patient require re-restraint, the restraints would be replaced and the MD immediately contacted for a new order. Fortunately, that doesn't happen very often.