Nursing Interventions for Patient Safety
The evolution of nursing is one that is rich in history and clinical practices and has existed for hundreds of years for health care issues. This author has work experiences from 1978 to 1996 as a nurse and nursing consultant in long term care and has a personal interest in how the use of restraints has evolved to a patient focused and caring approach that has reduced the rates of restraint use and patient injuries. Nursing evidence based practices for patient safety evolves from current technological advances, research and nursing theory. The purpose of this paper is to address how nursing clinical practices evolved for the use of patient restraints in health care facilities.
Identification and Discussion of Health Care Issue
The Centers for Medicare & Medicaid Services (CMS) defines a physical restraint as “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one’s body” (U.S. Department of Health and Human Services, 2001). Physical force can be human, mechanical devices, or a combination. Some Items that can be used to physically restrain people include bed side rails, waist belts, vests or jackets, hand mitts, arm and leg restraints.
This author has witnessed wheel chairs being tied to hallways handrails; patients tied into wheel chairs with sheets; bed sheets wrapped tightly around patients in bed restricting movement; all four extremities tied down to beds to prevent the patient from wandering; improperly applied restraint causing asphyxiation and untrained staff ordering and applying restraints. Chemical restraints are psychoactive medications used to control a person’s behaviors without medical...