Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Background
  • The province of Ontario in Canada enacted the Patient Restraints Minimization Act, 2001 (Bill 85) available at: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_01p16_e.htm. Despite enactment front line healthcare providers continue to voice strong concerns regarding the use of restraints with reports of injury and death even when less restrictive methods are used.
  • The College of Nurses of Ontario (CNO), (rev. 2009c) defines restraints as: physical, environmental or chemical measures used to control the physical or behavioural activity of a person or a portion of his/her body. Physical restraints limit a client’s movement.
    Physical restraints include a table fixed to a chair or a bed rail that cannot be opened by the client.
    Environmental restraints control a client’s mobility e.g. a secure unit or garden, seclusion or a time out room.
    Chemical restraints are any form of psychoactive medication used not to treat illness, but to intentionally inhibit a particular behaviour or movement.