How to Restrain a Patient in a Wheelchair

In hospitals and nursing homes, it's sometimes necessary to restrain patients for safety reasons--usually to prevent them from harming themselves, but on occasion to keep them from hurting others. For example, restraints are used when a confused patient has pulled IVs or tubes out of his or her body. A wheelchair restraint may be used for someone who is likely to wander away and get lost.

Things You'll Need

• Restraint
• Wheelchair
• Physician's order

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Instructions

• 1

  Determine that there is a valid need to restrain the patient. Consider your legal and ethical obligations as a health care worker, and realize that an individual shouldn't have his or her movement restricted simply for the caregiver's convenience.

• 2

  Contact the patient's physician, and get an order for the use of restraints.

• 3

  Decide which type of restraint is most appropriate for the situation. Use the least-restrictive device you can. Choose a belt or vest for patients who need to remain in a wheelchair, wrist or ankle restraints to restrict movement of hands or legs and mitten restraints for patients who scratch themselves or continually get out of wrist restraints.

• 4

  Read the directions on the tag attached to the restraint, as each manufacturer and type of device has certain specifications. Pay attention to safety warnings, especially when using a vest, because the patient may suffocate if it's applied incorrectly. Ask a coworker for help if you're not sure how to use a restraint.

• 5

  Apply the restraint correctly. Use a quick-release knot, also called a slipknot, to fasten devices that don't have a buckle. Fasten the ties to a part of the wheelchair that the patient can't easily get to. Place a call light within the patient's reach and make sure he or she knows it's there.

• 6

  Check on restrained patients at least every 15 minutes. Remove the restraint at least every two hours to check for skin irritation and proper blood circulation, exercise the joints that are inhibited by the restraint and determine whether the device is still necessary.

• 7

  Get a new order from a physician if the patient needs to be restrained the following day. By law, a doctor's order for restraints expires after 24 hours.