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Discussion

Restraints in acute care

I've already asked this from the nurses in the UK, but I'm only more curious! I work in a 16 bed med/surg ICU in the US. We routinely use soft wrist restraints, along with sedation, on intubated patients (we're trying to reduce usage). I'm interested in the use, or non use, in other countries (was suprised when I first read of the almost nonexistent use of restraints in UK). And, what do you do with other issues--patient's pulling out central lines, NG's on a frequent basis?

I would like to share "real" stories with my coworkers on this subject, just not the facts of research studies. Michele

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We use them on anyone who is at risk of pulling their tubes - basically, if they move their hands up and they won't or can't follow verbal instructions to get their hands away from their faces, they get the restraints. At one hospital I've worked at, they just apply them and that's that, and at the other, they apply them and then let the doc know so the doc can write the legal order for them. HTH, not terribly interesting though!

I don't work in ICU, so the situation is a little different. We rarely use restraints, in part because of a Coronial investigation following ht edeath of a restrained patients (the Coroner found that restraint was the proximal cause of death).

Instead we use patient attendants, who perform a 1:1 non-nursing special, watching the patient and preventing them from getting ot of bed, removing tubing etc. That's the ideal situation - on occasion you get them coming up with something (an NG, a CVC, a trache!) saying "they just pulled this out, sister."

In public hospital ICUs, at least in Victoria, patients are nursed 1:1, which might help catch potential tube removal before it happens.

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Thanks for taking the time to answer. I appreciate it, Michele

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