BACKGROUND Critically ill patients frequently experience severe agitation placing them at risk of harm. Physical restraint is common in intensive care units (ICUs) for clinician concerns about safety. However, physical restraint may not prevent medical device removal and has been associated with negative physical and psychological consequences. While professional society guidelines, legislation...

This statement defines physical restraint and provides recommendations for its use in children and adolescents. Mechanical restraint and physical holding are described. The primary focus of the statement is on mechanical restraint. Recommendations: Explain the procedure to the child; physician's order is used; when intervention is used, communicate in writing to parents; physical assessment. It...

PURPOSE It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental health. DESIGN AND METHODS We used all nursing home...

A point prevalence survey among 125 patients in two units of a rehabilitation facility showed that the physical restraint rate was 12.8% (n=16). The survey examined the reason(s) for restraint use, whether its use had been explained, consent obtained and documented, whether the restraint had been appropriately applied and patients monitored during the period when restraint was applied, and whet...

BACKGROUND Patients within the adult intensive care unit have the potential to develop delirium and agitation. This can result in the patient displaying unwanted behaviours such as attempting to remove the medical devices to which they are attached. Some adult intensive care units within the UK are starting to adopt physical restraint as a method of managing unwanted behaviours. AIM To determ...

AIMS AND OBJECTIVES To investigate (1) the prevalence of physical restraints and psychoactive medication, (2) newly administered physical restraints, frequency of application of the devices and frequency of psychoactive medication on demand during 12-month follow-up and (3) characteristics associated with restraint use in nursing homes. BACKGROUND High quality data on restraint use in German ...

Corticotropin-releasing hormone (CRH) mediates responses to a variety of stressors. We subjected rats to a 1-h period of an acute stressor, physical restraint, and determined the impact on subsequent sleep-wake behavior. Restraint at the beginning of the light period, but not the dark period, increased waking and reduced rapid eye movement sleep without dramatically altering slow-wave sleep (SW...

The authors describe a program to reduce the use of physical restraint on three psychiatric units of a university hospital. One component of the program involved interviewing patients to determine their stress triggers and personal crisis management strategies. The second consisted of training staff members in crisis de-escalation and nonviolent intervention. During the first two quarters after...

Rates of restraint and seclusion on a child and adolescent unit were evaluated before and after the implementation of a restrictive state law which was designed to reduce the monthly rates of restraint. Overall, the total number of hours in restraint, corrected for mean daily census, decreased significantly. The average number of patients in chemical restraint stayed about the same. There was a...