Question

the state of being physically constrained

Answer 1

Question:The state of being physically constrained

Answer:

Introduction:

          This question refers to the physical restrain that nurses use as devices or interventions for patients who are violent or aggressive, threatening to hit or striking staff, or banging their head on the wall, who need to be stopped from causing further injury to themselves or others.

          The patient on a restrain is said to be a physically constrained individual.

Literal Meaning of Constraint:

Constraint is a kind of restriction placed on some one by something due to which the constrained person’s freedom to act in a particular way becomes limited.

Literal Meaning of Restraint:

Restraint gives the meaning of a limit or control placed on some one or something by another, when it is sensible or necessary to do so.

          Example of restraint: A mother holding a 4 years old kid tight, in the beach so that he doesn’t run towards the sea.

Categories of restraints

Three general categories of restraints exist

• Physical restraint
• Chemical restraint
• Seclusion.

1)Definition of Physical restraint:

Physical restraint can be defined as any device, material or equipment attached to or near a person's body and which cannot be controlled or easily removed by the person and which deliberately prevents or is deliberately intended to prevent a person's free body movement to a position of choice and/or a person's normal access to their body.

A physical restraint may be used for either nonviolent, nonself-destructive behavior or violent, self-destructive behavior.

Ø Example: A arm restraint used when a nurse starts an IV cannulation for an aggressive psychiatric patient so that the procedure can be performed easily.

• Also, holding a patient in a manner that restricts movement such as when giving an intramuscular injection against the patient's will is considered a physical restraint. A physical restraint may be used for either nonviolent, non self-destructive behavior or violent, self-destructive behavior.
• Examples of physical restraint include vests, straps/belts, limb ties, wheelchair bars and brakes, chairs that tip backwards, tucking in sheets too tightly, and bedside rails.

2) Chemical restraint:

Chemical restraint involves use of a drug to restrict a patient’s movement or behavior, where the drug or dosage used isn’t an approved standard of treatment for the patient’s condition.

For example: Sedatives, Antipsychotics, and Anxiolytics.

3) Seclusion

Seclusion means a patient is held in a room involuntarily and prevented from leaving. Many emergency departments and psychiatric units have a seclusion room.

Seclusion is used only for patients who are behaving violently. Use of a physical restraint together with seclusion for a patient who’s behaving in a violent or self-destructive manner requires continuous nursing monitoring.

Roles of responsibilities of nurse when constraining a patient physically:

1. Nurses are ethically responsible to ensure the patient’s basic right not to be subjected to inappropriate restraint use.

1. Restraints must not be used for coercion, punishment, discipline, or staff convenience.

1. Use restraints only to help keep the patient, staff, other patients, and visitors safe and only as a last resort.

1. Make sure a physical restraint is applied safely and appropriately.

1. Monitor and assess the patient frequently

1. To relieve the patient’s fear of the restraint, provide gentle reassurance, support, and frequent contact.

1. Monitor vital signs : pulse, respiration, blood pressure, and oxygen saturation, to help determine how the patient is responding to the restraint.

1. Periodically check the readiness of the patient to wean from the restraint.

1. To help ensure a restraint is applied safely, nurses should receive hands-on training on safe, appropriate application of each type of restraint before they’re required to apply it.