CNA Chapter 12: Restraint Use Guidelines

Restraint Usage

• Restraints should only be used when less restrictive measures fail to protect the individual or others.
• A doctor's order is mandatory for the application of restraints.
• CMS, FDA, TJC, and state agencies set guidelines for the appropriate use of restraints.
• Restraints are not permitted for discipline, punishment, or staff convenience.

Types of Restraints

• Chemical Restraint: Any medication used for discipline or convenience rather than to treat medical symptoms.
• Physical Restraint: Devices or methods that restrict movement or access to one's body (e.g., clamps, vests).

Enablers vs Restraints

• Enablers are devices that limit movement to promote independence and safety but can be easily removed by the person, such as lap trays or raised bed rails.

Risks of Restraints

• Associated risks include cuts, bruises, fractures, and the most serious risk: death from strangulation.
• Increased use of restraints can lead to confusion and agitation in individuals.

Safety Guidelines

• Restraints must protect individuals, requiring frequent checks (every 15 minutes) and removal or release at least every 2 hours.
• Maintain quality of life and follow manufacturer's instructions when applying restraints.
• Proper reporting includes type, duration, skin condition, and behavioral changes of individuals in restraints.

Legal and Ethical Considerations

• Restraints are considered false imprisonment if deemed unnecessary.
• Informed consent is necessary prior to applying restraints.

Reporting Requirements

• Any death related to restraint use must be reported to CMS if it occurs during or shortly after restraint application or removal.

Restraint Alternatives

• Prioritize understanding and addressing the underlying causes of behavior before resorting to restraints.
• Techniques such as padding corners and using safe environmental modifications are effective alternatives.

Definitions

• Freedom of Movement: The ability of an individual to change their body position at will.
• Medical Symptom: An indication of a physical or psychological condition needing attention.

Instructional Guidelines

• Always apply restraints as per the manufacturer's instructions.
• Regularly assess the individual for comfort and proper alignment, especially during restraints application.

Special Restraints

• Wrist restraints are used to prevent individuals from pulling out medical devices.
• Vest restraints require monitoring to ensure they are snug yet not constricting.
• Adjunct devices like roll belts allow limited movement without compromising safety.

Explore the essential guidelines and regulations surrounding the use of restraints in healthcare as outlined in Chapter 12 of your CNA study materials. This quiz covers important definitions, the roles of healthcare professionals, and the agencies involved in setting these standards. Test your knowledge to ensure safe and compliant practice.