Chemical Restraints

Any drug given to change a client’s behavior—such as wandering, restlessness or yelling—may be considered a chemical restraint.  Chemical restraints are drugs that are not necessary for the client’s medical condition but are used as a means of discipline or convenience, such as giving a client a drug in order to keep him in one place.

• Studies have shown that medications are usually not very effective for changing behaviors like pacing, wandering, being uncooperative or being agitated.
• Restraints may only be ordered when there is a temporary, specific medical reason for it.  A restrained client must be monitored carefully and frequently for comfort and safety.

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.