The Registered Psychiatric Nurses Association of Saskatchewan discourages the use of restraints in any health care setting. Restraints should only be initiated in situations when other interventions are determined ineffective for ensuring the safety of the client and others. While the use of restraints may be appropriate in specific circumstances, this use must be order by a physician, and only a physician or Registered Nurse/Registered Psychiatric Nurse have the authority to initiate a restraint.
Chemical agents, environmental barriers and physical devices that inhibit the client in autonomous, independent, spontaneous action are inclusive within the realm of restrains. All staff with direct client contact must have ongoing education and training in alternative methods to avoid the use of restrains, as well as in the appropriate and safe use of restrains when absolutely necessary.
The components of quality must be considered when initiating the use of restraints: acceptability, accessibility, appropriateness, effectiveness, efficiency, competence, continuity, and safety. Time limits must be in place for the duration of use of a restraint and time frames for monitoring the clients where restraint is utilized must be established. As well, the most appropriate type of restraint should be considered. Consideration of the use of restraints must include a focus on the rights and well-being of the client.
Agencies should have the necessary policies in place to assist staff to determine the appropriate use of restraints. Thorough record keeping and review of practices are essential in determining the outcomes where restraints are used. All such situations should be fully documented and evaluated to determine whether they meet the standards of the agency.
Approved by Council
December 2001