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- Use side rails when a patient is restrained. If necessary, use a bolster or gap protector to prevent the patient from sliding between split side rails or between the mattress and side rails.
- A patient restrained on his/her back must be carefully observed in case he/she vomits. He/she could aspirate the vomitus. Elevate head of bed unless contraindicated.
- Restraining a patient may lead to increasing restlessness or agitation.
- Cool fingers or toes, bluish nailbeds, change in color of extremities, changes in VS, difficulty breathing, discomfort or change in responsiveness should be reported immediately and the restraint checked and loosened or removed.
- Emotional or psychological problems such as embarrassment, humiliation, feelings of isolation or being dehumanized may result from the use of restraints.
- Use of restraints may lead to deconditioning, decreased strength, skin breakdown, decreased ability to walk, or contractures.
- Use of siderails to prevent a patient from getting out of bed may contribute to more severe falls, since the patient may fall from a greater height by climbing over the rails. Consider using 2 siderails and the lowest bed height to facilitate safe exit from bed.
- Inform patient and family the reasons for applying restraints.
- Pay particular attention to patient's need for food, fluids, and toileting.
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