Table of Contents
REQUIREMENTS #
- Assisting nurse(s) (depending on the degree of aggression)
- Tray for IM injection:
- 10mls sterile syringe
- Two (2) sterile hypodermic needles
- Receiver for sterile cotton wool swabs
- Cleansing lotion
- Receiver for used cotton wool swabs
- Medication(s) to administer (according to prescription)
- Patient’s treatment chart
- Patient’s folder (Electronic/Manual)
- Straitjacket, leather straps, belt etc.
- Blanket/thick cloth
- Seclusion room
STEPS #
- Advance Preparation
- Develop goals to contain/control the aggressive behavoiur
- Select the restrain approach to use
- Explain carefully to patient and family (if present) the importance of restraint
- Identify assisting nurses needed and tell them their roles
- Prepare equipment to be applied for the selected restraint approach
- Establish rapport( refer procedure) and explain procedure to patient
- Inform the patient on the type of restraint selected and anticipated duration
- Call the assisting nurses and remind them of their roles
- Assemble and bring the prepared equipment to be used for the selected restraint approach (e.g. sedative and tranquilizers, leather straps, straitjackets etc.)
- Give a cue to the team to approach patient simultaneously
- Lead team to approach patient in an appropriate manner (e.g. from the front, in a semi-circle formation, etc.)
- Speak to patient in a firm but calm tone giving him specific and concise direction
- Direct patient towards nearest wall or floor
- Hold blanket between you (nurse) and patient if he/she is holding any dangerous object
- Grasp patient simultaneously by the clothing at the waist and above the joints of the limbs (the great joints)
- Carry patient to bed/chair and apply selected restraint approach i.e. physical (e.g. leather straps) for the period required to calm him/her down or chemical (e.g. administer prepared injection) or environmental(e.g. put patient into seclusion if prescribed)
- Assess any injuries to patient, other patients or staff
- Assess the effects of the restraint on the patient
- Ensure that all equipment used are cleaned/disinfected and stored accordingly
- Perform hand hygiene
- Continue to observe the effects of medication/seclusion protocol on patient at frequent intervals
- Document assessment before and after the restraint in nurses’ note and patient’s folder