Question
Can you explain the definition of restraint and examples of restraints?
Answer
The definition of a physical restraint is any manual method, physical or mechanical device, material or equipment attached or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body. I will give you several examples of restraints. A reclining geri-chair would be considered an example of a restraint. An upright geri-chair with a lap tray, any standard wheelchair or any other seating that prevents the resident from rising from the seat due to physical functioning deficits; basically what we mean by that is if you have a person who can stand up, but if you change the angle at the hip such that it is a very acute angle, they are not able to stand up. You make your seating system or your wheelchair such that you really recline the patient and you wedge them in there, that could be considered a restraint, even though they do not have a lap belt, a lap tray, or anything else. Other examples would be devices that hold the resident in the chair that cannot be easily removed by the resident like a seatbelt that is not self-releasing. You can even have a self-releasing seatbelt that can be considered a restraint if the resident is unable to remove it in a timely fashion. Lap buddies are often times used because a lot of facilities and nursing homes will think they could just use a lap buddy because they can pull it out of there, but in fact it is a restraint if the resident cannot remove it in a timely fashion. Lap trays that the resident cannot remove are considered restraints. Again that could be one that attaches in the back as a full lap tray or it could even be a half lap tray. It could even be a half lap tray that swings away, if the resident is not able to swing it away. Using bed rails to keep a resident from voluntarily getting out of bed and placing a resident in a wheelchair close to the wall to prevent rising are additional examples. When you are considering a restraint, you always want to consider is it taking away some movement or some ability to move that the patient might have? If you are restricting their freedom of movement, then yes, it would be considered a restraint. For example, there is an individual, lying in the bed, who is contracted. All four extremities have no active movement. In order to get in and out of that bad, they are a total lift. You physically need a lift them out. If you place those bed rails up, are you taking away any sort of function or movement of that patient? The answer would be no. In that case, they are not considered any sort of restraint.
