Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

List of factors that may increase likelihood of use of restraints

Predisposing Factors

 

Examples of Predisposing Risk Factors for Restraint Use

1. Advancing Chronological Age

2. Cognitive Changes
    -Moderate-severe dementia
    -Trauma

3. Decreased/Inability to Communicate
    -Aphasia

4. Fecal & Urinary Incontinence
5. History of Falls/ Fear of Falls
6. Increasing Dependence
    -Decline in mobility
    -Increasing dependence for activities of daily living
7. Psychiatric Conditions
8. Responsive Behaviours
    -Aggression, history of violence, injury to self or others
    -Anxiety
    -Challenging/Disruptive behaviours
    -Reslestness, wandering
    -Risk of injury to self or others

9. Sensory Impairments
    -Deafened or hard of hearing
    -Blind of low-vision impairment

Precipitating factors 

 

Examples of Precipitating Risk Factors for Restraint Use

Cognitive Changes:
-Delirium
-Dementia
-Sundowning
-Unable to remember instructions

Decreased Mobility:
-Bedridden
-Lack of assistive devices

Environmental Factors:
-Music
-Noise
-Temperature
-Unfamiliar environment

Falls
Medications Influences: 
-Alcohol and substance abuse
-Benzodiazepines
-New medications
-Polypharmacy
-Psychoactive agents
-Unanticipated side effects
Multiple Admissions
Surgery/ Procedural Interruptions
Unmet needs:
-Anxiety
-Fear
-Hunger
-Pain
-Thirst
-Toileting