Physical Restraints

A physical restraint is any method or device used to restrict movement or to keep a client in a certain position while sitting or lying down. 

Examples of physical restraints include:  

• Posey vests
• Lap belts
• Wrist and ankle straps
• Chairs with locking trays or roll bars
• Mittens
• "Geri-chairs” 
• Straitjackets

Even a wheelchair can be considered a physical restraint if it is used for the convenience of the staff rather than due to a medical reason.

Physical restraints are regulated by the Food and Drug Administration (the FDA) because they are considered medical devices that must be considered medically necessary and be prescribed by a physician.

SOME ALTERNATIVES TO RESTRAINTS

• Use cushions and/or wedges to keep clients from sliding out of chairs.  Place the cushion under their thighs to keep them from slipping and to help them maintain proper posture while seated.
• Make sure that a chair is the correct size for a client.  You can also put a nonslip material on the seat of a chair to prevent sliding.
• If possible, use a chair alarm (such as a sensor on the seat) for a client who shouldn’t get up without assistance.
• Keep the client close to the nurse’s station or other area where he or she can be observed easily.
• Create a special (safe) area with lots of interesting activities to occupy your client’s time and attention.
• Be sure to see to your clients’ personal needs including thirst, hunger, toileting and social activities.  If their needs are met, they might be less likely to get up without assistance or to wander.
• Try having your clients listen to soothing music.  Studies have shown that music relaxes clients who tend to wander or be agitated.

THE BOTTOM LINE: If you can’t change a client’s behavior, then change the environment.