Restraint Use Policy and Procedure

Restraint is used only after other alternatives have failed 

Restraint Committee meets monthly and evaluates the restraint use of all residents in the facility

When improvement or decline in facility rate of restraint use is noted, causes are investigated 

Staff is educated about the facility restraint program through orientation and regular inservices 

If a resident is admitted with a restraint, a Restraint Assessment is completed 

Admission assessment includes evaluation of balance, strength, gait, transfer, and safety 

Restraint Assessment is completed before any restraint is applied 

Restraint use is reevaluated weekly or as soon as staff has determined a change has occurred 

Physician’s Order is obtained before restraint use, and states the medical symptoms requiring restraint, what type of restraint is to be used, and when the restraint is to be used 

The underlying causes of the medical symptoms are investigated, and interventions are implemented to eliminate those causes 

If underlying causes cannot be eliminated, the facility tries alternative measures before the restraint is used 

If alternatives are unsuccessful, the least restrictive form of restraint is applied 

Side rail use is addressed in the same manner as any other restraint 

Side rails used as an enabler are supported by documentation 

Physician’s order includes instructions to check the restraint every 30 minutes, and to release it every 2 hours for 10 minutes. These instructions are carried over to the Treatment Administration Record and the Nursing Assistant Care sheet 

During restraint use resident is regularly monitored for potential negative outcomes, and to make sure all needs are met 

Consent is obtained from the resident’s family member or responsible party before applying restraint 

Obtaining informed consent includes instructing the resident’s family member about alternatives to the restraint, what potential negative outcomes there may be, and the right to refuse the restraint 

The Restraint Consent form is filled out and signed for each type of restraint and for each episode of restraint use 

Restraint use is addressed on the MDS 3.0 assessments, Resident Assessment Protocols, and in the care plan 

Care plan interventions include measures to minimize or eliminate the medical symptom requiring restraint use 

Interventions include programs to prevent functional declines, such as exercise and restorative programs for transfer, gait, and balance

More information on restraint policies, procedures, regulations, and care planning can be found in the book:

Restraints Manual for Long Term Care