Question

The nurse-manager observes that the staff nurse has used wrist restraints to help secure an elderly female in her wheelchair. The client is pleading for the nurse to release her arms. The nurse explains to the nurse-manager that the client needs to be restrained in the wheelchair so that the nurse can change her bed linens. What is the priority action by the nurse-manager?

a. Determine if the client has a PRN prescription for an antianxiety agent.
b. Contact the healthcare provider to ensure that a prescription for restraints was written.
c. Close the door to the room to avoid disturbing other clients in nearby rooms.
d. Advise the staff nurse to remove the restraints from the client's wrists.

Answer 1

The nurse-manager should contact the healthcare provider to ensure a prescription for restraints exists and if not, advise immediate removal of the restraints. Restraints should only be used as a last resort and under strict guidelines, always considering the patient's safety and rights.

Step-by-step explanation:

The priority action by the nurse-manager in this scenario is to ensure that the use of restraints is appropriate, ethical, and legal. This involves making sure that there is a current prescription for the restraints in place. The nurse-manager should first contact the healthcare provider to verify if a prescription for restraints has been written and is valid. If a prescription does not exist, the nurse-manager must advise the staff nurse to immediately remove the restraints. The focus should always be on the patient's safety and rights, and any action should comply with best practices and legal requirements in healthcare settings.

Restraints should be used only as a last resort when all other options have failed and when the patient's behavior poses an imminent threat to their own safety or the safety of others. In a case where restraints are deemed necessary, they must be used under the direct supervision of a registered nurse who is capable of assessing and responding to patient needs. It is also crucial that the patient's dignity and comfort are considered, and using restraints for staff convenience is not an acceptable practice.

In clinical practice, thorough documentation and providing dialysis treatments, for instance, require attention to detail and adherence to protocols to ensure patient safety. Similarly, the use of restraints should follow strict guidelines, including proper assessment, documentation, and regular monitoring of the patient. Every action taken by healthcare professionals should align with the overarching goal of delivering high-quality and compassionate care.