Use restraints only as a last resort" is a common refrain nowadays that every healthcare professional should be aware of. Following some basic guidelines on the judicious use of restraints will minimize your risk of being sued.

Restraints are most often used for patients who are likely to fall or who've tried to disrupt their therapy; typically older, confused patients or those who suffer cognitive impairment, have difficulty walking, or are severely ill. In such cases, failing to use restraints could result in a claim or lawsuit being brought against you if the patient suffers harm.

But a desire to safeguard the patient's well-being may not be enough of a reason to use restraints, if other, less restrictive options are available. If a wheelchair-bound patient is at risk for falling, for example, try wedging pillows against the side of his wheelchair. Or use a lap tray to provide support and keep him from slipping.

If these options don't work, follow your facility's policies and procedures for obtaining a doctor's orders for restraints. Keep in mind that restraints can only be used for medical reasons, never as a punishment, for the convenience of staff, or as a substitute for supervision. Thoroughly document that the less restrictive alternatives were ineffective in protecting the patient from harm.

Follow your facility's protocol for how frequently you need to assess and record the patient's condition while he is restrained. Following federal guidelines, your facility will probably require you to loosen the restraints every two hours for 10 minutes to prevent discomfort or skin irritation, allow the patient range of motion, and give him greater freedom to eat or go to the bathroom.