Physical Restraint Essay

How is the decision made when to use physical restraints in the elderly? What is the rationale and outcome for the patient who has been physically restrained? I recognize that restraints can be both physically and chemically applied to a patient of any age, but due to limitations of this paper the focus will be on the use of physical restraints in the elderly population.“Physical restraint refers to any device attached to or adjacent to a person’s body that cannot be controlled or easily removed by the person, and deliberately restricts a person’s freedom of movement and/or prevents a person’s normal access to his or her body” (Kwok et al., 2012, p. 645). The use of physical restraints is an ethical dilemma that nurses encounter when caring

Physical restraints can consist of but not limited to all four bedrails up, restrictive vest and jackets, wristlets and anklets and leg and waist belts that clasp in the back. Physical restraint is basically any device that restricts the movement of a patient (Hill & Fauerbach, 2014). The environment and the patients current health status is another key factor in the use of restraints. Is the patient suffering from a delirium, dementia, or a physical injury that they do not understand and need to be confined to promote a return to health (Mohler & Meyer, 2014). All these factors can play a key role in wether of restraints are necessary or not. When a patient is suffering with a cognitive defect that will not change then the need to adapt the environment is a crucial part of patient safety and comfort verses the use of physical restraints. However, if the patient has suffered a physical injury that requires restrictive movement then the use of physical restraints may be appropriate for a certain length of time to allow the patient to recover and return to health (Mohler & Meyer,

“Restraints also increase an older adult’s risk of delirium and agitation and lead to deconditioning, functional decline, walking dependency, and incontinence. Restraints can cause direct and indirect injury, including strangulation, asphyxiation, trauma, aspiration, and cardiac arrest”(Enns, Rhemtulla, Ewa, Fruetel, & Holroyd-Leduc, 2014, p. 541). It is clearly indicated by research that the use of physical restraints has had a negative impact on this vulnerable population causing increase discouragement due to the experiences of being restrained (Enns, Rhemtulla, Ewa, Fruetel, & Holroyd-Leduc, 2014). Although restraints are used for various reasons it is crucial to understand the impact it has on the elderly patient. The nurse needs to determine the risk verses harm reduction ratio to the patient in ordered to make a sound ethical