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Hospital Restraint Protocols

While hospital restraint protocols are not standardized across the whole country, the base reasoning from facility to facility is fairly consistent. The U.S. Government has released loose guidelines and each facility develops its own policies. The policies constantly change as societal norms change or new versions of restraints are created.

  1. Agitated or Restless Behavior

    • A patient's agitated or restless behavior may result in restraining the patient for the safety of hospital workers if the patient is belligerent patient and uncontrollable. The patient's agitation can be psychological or drug and alcohol induced. Combative patients are dangerous to the caregivers and must be restrained to keep the employees safe. While drugs might lessen the patient's ability to harm employees, physical restraint is the only way to ensure consistency for safety.

    Interference with Therapy

    • For trauma patients, restraints may be used for the security of the spinal column. A patient with a major head injury might not remember to stay still. If he is passing in and out of consciousness, he could move without knowing about it. If the spinal column has been compromised, this movement could be dangerous and life altering to the patient. While deep drug sedation limits mobility, hard restraints are effective for when the drugs begin to wear off.

    Wandering or Elopement

    • Elderly patients with dementia or Alzheimer's may exhibit wandering/elopement behavior. Due to the patients' tendency to wander off, forgetting where they are or why they are there, it is for the safety of the patients that they be restrained to a secure area. While this is not the preferable way to treat such a patient, for those with "Sundowners," it might be the only way to keep them in the room when a nurse is not around. Sundowner's hits in the evening; these patients are typically fine throughout the day but get drastically confused and disoriented toward the end of the day, making them a flight risk.

    Cognitive Impairment or Fall Risk

    • Cognitive impairment and fall risks are two of the broadest categories when it comes to deciding to restrain a patient. This can result from anything from drugs to dementia for cognitive impairment. For fall risk, it ranges from children to the elderly to a non-compliant injured patient who attempts to do things on her own. These situations often call for soft restraints, just to ensure the patient does not try to get out of bed without assistance.

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