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  • Essay / Restraints Essay - 775

    A restraint is any physical or chemical measure used in a healthcare setting to prevent a patient from being free to move (Craven, Hirnle, & Jensen, 2013). Nurses face dilemmas when deciding whether to use restraints to protect the patient from falls, injury to self or others, suppress agitation, and facilitate treatment. Misuse and misconceptions about restraint can have negative consequences, including physical and psychological problems. Physical and psychological harms related to restraint could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). . Nurse education can reduce the use of restraint by increasing knowledge, changing attitudes and providing alternatives to treatment. Policy changes within the facility may also be necessary, as well as education to reduce patient restraint when an alternative could have been used. Yeh et al. (2004) showed positive results in a study titled The Effects of Continuing Education on Reducing Stress on Novice Nurses in Intensive Care Units. Pre-test and post-test questionnaires were used among 37 novice nurses in Taiwan to assess outcomes in terms of knowledge, perception, attitude, and clinical practice of restraints. A four-hour lecture on restraint reduction was presented and results were measured three days later. Restraint knowledge increased significantly in the post-test questionnaire. This knowledge included innovative ways of using it as an alternative to restraints. Perception of the use of restraints improved significantly after being lectured on several misconceptions about the use of restraints to prevent patient injury, including restraint to prevent paper rods, chairs' special angled cushions, anticipate patient toileting needs, position changes, and location changes (Craven, Hirnle, & Jensen, 2013). Negative elements of teacher training could include the time and money spent on the program, which would deprive certain areas that may be understaffed. This could contribute to increasing the use of restraint, due to lack of time to implement alternative therapies. Institutional policies and the repercussions of improper use of restraints can ensure greater compliance than education alone. A combination of both may be necessary to improve the situation. Another negative is that attitudes after education may remain the same and not change the practice of trying alternative therapies first. Continuing education can help change these attitudes in the long term and lead to better patient care..