Restraint belt is a specific intervention or device that prevents the patient from moving freely or restricts normal access to the patient’s own body. Physical restraint may involve:
● applying a wrist, ankle, or waist restraint
● tucking in a sheet very tightly so the patient can’t move
● keeping all side rails up to prevent the patient from getting out of bed
● using an enclosure bed.
Typically, if the patient can easily remove the device, it doesn’t qualify as a physical restraint. Also, holding a patient in a manner that restricts movement (such as when giving an intramuscular injection against the patient’s will) is considered a physical restraint. A physical restraint may be used for either nonviolent, non self-destructive behavior or violent, self-destructive behavior.
Restraints for non-violent, non self-destructive behavior
Typically, these types of physical restraints are nursing interventions to keep the patient from pulling at tubes, drains, and lines or to prevent the patient from ambulating when it’s unsafe to do so—in other words, to enhance patient care. For example, a restraint used for nonviolent behavior may be appropriate for a patient with an unsteady gait, increasing confusion, agitation, restlessness, and a known history of dementia, who now has a urinary tract infection and keeps pulling out his I.V. line.
Restraints for violent, self-destructive behavior
These restraints are devices or interventions for patients who are violent or aggressive, threatening to hit or striking staff, or banging their head on the wall, who need to be stopped from causing further injury to themselves or others. The goal of using such restraints is to keep the patient and staff safe in an emergency situation. For example, a patient responding to hallucinations that commands him or her to hurt staff and lunge aggressively may need a physical restraint to protect everyone involved.