Nursing-change theory, patient restraints
Running head: PATIENT RESTRAINT PROTOCOLS Patient restraints have been a hot issue within the past ten to fifteen years in nursing. There have been numerous studies done on the adverse affects restraints have on patients, physiologically and psychologically. Anger, fear, impaired mobility, bladder and bowel incontinence, eating difficulty, skin breakdown, and nosocomial infections have all been associated with the use of restraints (Weeks, 1997; Janelli, 1995). Therefore, there has been a move to limit the use of restraints and develop safer protocols for the times that they are used. All hospitals, today, have restraint protocols that nursing staff should follow when implementing the use of restraints. However, the nursing staff does not always follow these protocols. Protocols often include making sure that the restraints have been tied safely, for easy removal, and doing frequent checks, at least every two hours, to assess for circulation and skin breakdown under and around restraints. This author has observed that the restraints are not always tied correctly. There have been times that restraints had to be cut off with
One solution is continuing education services on restraint documentation and how to tie restraints on properly. The goals for a planned change project should include improving nursing education among medical-surgical nursing staff; evaluating knowledge and practice; discovering other methods to check compliance of staff in following restraint protocols. RAP: a restraint alternative protocol that works. Journal of Gerontological Nursing, 22 (6), 8-16. Communication and education about the improper documentation of restraints and improper tying of restraints can be attempted through staff meetings and informal discussions. The staff could alternate among themselves the assignment. In stage one, building a relationship, the nurse manager can use several strategies to facilitate the change process among the staff. However, no studies have investigated if the documentation truly demonstrates compliance. Some of the reasons nurses restrain patients are to prevent them from harming themselves or others, to help maintain treatment plans, and to control confused or agitated patients (Stratmann, Vinson, Magee and Hardin, 1997). Staff meeting discussions will be held to provide feedback from staff to the nurse manager and provide information on the need for any further changes. Daily interaction between the nurse manager and the staff helps to clarify any uncertainties regarding the new standards (Winston et al. The patients can range in age from 18 to 100 Patient Restraint 3years old.
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