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The Effectiveness of Restraints on Patient Care

Within the health care field, psychiatric patients are individuals that are
often restrained to prevent physical harm to themselves or others.
Restraints can be categorized into 3 types: physical, environmental and
chemical. Physical restraints are any object that restricts the movement of
an individuals limbs including bedside rails and limb ties; Chemical restraints
are frequently drugs that restricts and individuals freedom and movement,
including sedatives and antipsychotics; environment restraints are place
where the individual cant move around freely that in and around their
environment including locked rooms and closed wards. Over the last decade
the attitudes, opinions, behaviours and emotions of the nurses restraining
patients have changed. We now think that restraints infringe on the patients
rights and do more harm than good. The goal right now is too reduce the use
of restraints as much as possible. To examine these variables, a survey was
distributed to the nursing staff that worked at the Lev Hasharon Mental
Health Centre in Israel that housed 400,000 residences. The participants
were asked to rate their agreement or disagreement on a series of
statements pertaining to their opinion and behavior as well as the emotions
felt by the nurse while they were restraining them. The study also asked
about the factors that initially lead them to restrain a patient.
According to this questionnaire, several environmental factors affected
the nurses willingness to restrain a patient; if the nursing staff are early in
identifying violence, if the patient were prescribed an adequate drug
treatment, if there are an adequate number of staff that are experienced,
and, surprisingly, if some of the staff are men; these factors reduced the

need to restrain a patient. The factors that affect the nurses willingness to
restrain a patient is different. These factors include the nurses qualifications
and gender. It was apparent in this survey that nurses with high
qualifications considered restraint as something therapeutic that can the
patient and staff cope with the violence, as opposed to lower qualified nurses
who feel that the restraints are used with the patient is engaging in irritating
or annoying behavior. The authors of this article speculate that there is less
alternatives available to lower qualified nurses. It is also of note that some
nurses with lower qualifications think restrains are a negative object that is
associated with humiliation and fear.
Gender also plays an important role in the nurses attitude towards
restraints. The majority of female nursing staff feel that restraints connote
negative emotions such as degradation and punishment. Men, on the other
hand, are usually more willing to restrain a patient but because violence
usually breaks out among female staff and the patient, men are usually
called to restrain the patient.
In 2001, the Ontario government legislated the Patient Restraints
Minimization
Act. This act specified when and how often restraints can be used; the goal is
to minimize the use of restraints to as little as possible. I think that
this reduction in restraints is a controversial issue. On one hand, we have
the safety of the client and on the other hand we have the safety of the
staff. With patients that are often violent and agitated, I can see why
restraints might be a part of their care; there are times when Ive heard
nurses were attacked by a client and required medical treatment.
This degree of violence does not happen often but it does happen

occasionally. Even in these situations, caution must be use when giving


chemical restraints or

Bibliography
1. Gelkopf, M., Roffe, Z., Werbloff, N., & Bleich, A. (2009). Attitudes, Opinions, Behaviors, and
Emotions of the nursing staff toward patient restraint. Issues in Mental Health Nursing, 30(12), 758763.
2. Goethals, S., Bernatte, & Gastmans, C. (2012). Nurses' decision-making in cases of physical
restraint: a synthesis of qualitative evidence. Journal Of Advanced Nursing, 68(6), 1198-1210.

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