- Nurses must have knowledge of the possible multiple medical, psychological and functional complications resulting from the use of restraints and be diligent in observation, monitoring and follow up.
|
|
|
Behaviour alterations ■ Increased agitation ■ Increased frustration |
|
Cardiovascular system alterations ■ Change in blood pressure, volume and basal metabolic rate ■ Cardiac stress ■ Venous stasis (blood clot, pulmonary emboli), lower extremity edema |
|
Death ■ Asphyxia ■ Aspiration ■ Strangulation |
|
Decreased functional status ■ Deconditioning ■ Increased dependency |
|
Fecal impaction |
|
Hydration and nutritional status alterations ■ Dehydration from lack of access to fluid ■ Loss of appetite |
|
Incontinence of urine and stool |
|
Infection ■ Nosocomial infections resulting from immobility (e.g. pneumonia) |
|
Injury ■ Falls causing injury |
|
Musculoskeletal alterations ■ Decrease muscle mass, tone and strength, stiffness ■ Contractures ■ Bone demineralization, osteopaenia |
|
Pain |
|
Perceptions of Self ■ Loss of autonomy and dignity ■ Changes in self image ■ Guilt |
|
Psychological ■ Anger ■ Anxiety ■ Depression ■ Fear ■ Sensory deprivation • Increased confusion • Disordered sleep ■ Trauma/ retraumatization |
|
Skin integrity alterations ■ Abrasion at restraint site ■ Bruising ■ Development of pressure ulcers |