Legal/ Ethical Aspects: Seclusions and Restraint

Question 1

Restraint

Answer 1

direct application of physical force to a person without his or her permission to restraint his or her freedom of movement

• prevent injury to self or others
• mechanical restraint
• human restraint

Question 2

Human Restraint

Answer 2

staff members physically control the client and move him or her to a seclusion room

Question 3

Mechanical Restraint

Answer 3

devices, usually ankle and wrist restraints, fastened to the bed frame to curtail the clients physical aggression. such as hitting, kicking, or hair pulling

Question 4

Seclusion

Answer 4

involuntary confinement of a person in a specially constructed, locked room equipped with a security window or camera for visual monitoring

• for safety, bed is bolted to the floor and a mattress
• any sharp or potentially dangerous objects such as pens, glasses, belts, or matches are removed
• seclusion decreases stimulation, protects others from client, prevents property destruction, and provides privacy for client

Question 5

Goal of Seclusion

Answer 5

give client opportunity to regain physical and emotional self control

Question 6

When is short-term use of restraint or seclusion permitted?

Answer 6

when the client is imminently aggressive and dangerous to himself or others

Question 7

Criteria for Removal of Restraints or Seclusion

Answer 7

-decreased muscle tension
-demonstrate self control
-make no verbal threats
>offer support to patients family, who may be angry or embarrassed when patient is restrained or secluded

Question 8

Steps to Avoid Liability

Answer 8

• practice within scope of state laws and nurse practice acts
• collaborate with colleagues to determine best course of action
• use established practice standards to guide decisions and actions
• always put clients rights and welfare first
• develop effective interpersonal relationships with the client and family
• accurately and thoroughly document assessment data, treatments, interventions, and evaluations