Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Possible Complications of Restraint Use

  • 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
    o   Loss of autonomy and dignity
    o   Changes in self image
    o   Guilt
·         Psychological
o   Anger
o   Anxiety
o   Depression
o   Fear
o   Sensory deprivation
§ Increased confusion
§ Disordered sleep
o   Trauma/ retraumatization
  • Skin integrity alterations
    • Abrasion at restraint site
    • Bruising
    • Development of pressure ulcers