• Never restrain a patient in the prone position. The prone position creates a risk for aspiration,
restricts the patient’s vision, and increases feelings of helplessness and vulnerability.
• Initiate nursing measures to prevent skin breakdown and other hazards of immobility.
• Release restraints safely at intervals according to your organization’s policy.
• Anticipate the need and assure that staff assistance is available when you release restraints at
intervals.
• Address needs for nutrition, hydration, toileting, and ambulation.
• When using 4-point restraints, never secure all 4 restraints to the same side of the bed. Doing so increases the risk for falling.
• If the patient is at risk for aspiration, position the patient on his side before restraining.
• Follow your organization’s policy and product’s instructions completely for application
procedure.
• Follow your organization’s policy strictly for monitoring and documenting.
• Secure restraints only to the bedframe or immovable part of a chair, stretcher, wheel chair, or
other equipment and never to side rail or other movable part.
• Always tie restraints using a quick release knot, slip knot, or bow.
• Leave 1 – 2 inches slack in restraint straps to allow movement.
• Assist the patient in whatever ways possible to meet the criteria for discontinuing restraints.
