Registered Nurses' Association of Ontario

Guiding Principles/Assumptions

  • Clients – patient, resident, consumer, family, significant others, substitute decision-maker (SDM) – are active partners in care to the extent of their capacity and in collaboration with the interprofessional health-care team.
  • The philosophy of individualized care is foundational to the therapeutic nurse patient relationship.
  • All client behaviour has meaning that is contributing to the underlying cause.
  • Prevention of the use of restraints starts with assessment and use of alternative approaches.
  • De-escalation techniques for crisis management can be used as a prevention strategy to avoid the use of restraints.
  • Leadership is required across all organizational and health care sector levels to create a move towards restraint free environments.
  • When restraint use is unavoidable, the least restrictive form of restraint is used for the shortest duration of time for avoidance of harm to self/others; restraint use is temporary and alternatives must continue to be considered.
Clinical Management
Promoting Safety: Alternative Approaches to the Use of Restraints
Background Information