It has been generally been accepted within the health community that using restraints on clients in either hospitals or long term care homes can help prevent falls or increase their sense of security.

But that’s a myth, according to the supporters of Saskatoon Health Region’s revised restraint policy for mechanical and environmental restraints.

Health worker assisting patient injured by restraints

Restraints, once thought to help keep clients safe, can actually lead to critical injuries, which is why the Saskatoon Health Region has rolled out a new policy called Least Restraint that cuts back on their use.

Saskatoon Health Region’s Least Restraint policy maintains that applying restraints to clients may actually increase their risk of injury, both physically and mentally, as they can impact a person’s psychological and social well-being.

A review of the policy was prompted by several critical incidents involving restraints within the Health Region. Clients were being injured by the devices meant to keep them safe.

“It seemed to be an ongoing issue,” noted Lana Prystai, RN and Professional Practice Leader and one of the supporters of the new policy. “Although we may know better, we continue to resort to restraints. We know we can do better.”

The Region-wide newly revised Least Restraint Policy, which is now in effect, is meant to reduce the use of restraints and have the use of the least restrictive restraint for the least amount of time.

There are certainly times when the use of restraints is appropriate, Prystai stated – instances where a client repeatedly attempts to remove their intubation, for example, or when someone’s safety or the safety of others is in jeopardy. But according to the new policy, restraints should be used only when all other alternatives have been exhausted.

The revised policy asks staff to conduct an extensive assessment of the client and the reasons why restraints are being considered, to use restraints only as a last, temporary measure, to choose the least restrictive restraints possible, and to diligently monitor those restrained. Restraints are not meant to be a long-term solution, so if a form of restraint is used, the need for it should be reviewed consistently and often.

The changes embedded by this revised policy will necessitate a culture shift for staff in the Region.

“For years, we’ve been told that restraints keep people safe,” said Daphne Kemp, Regional Fall Reduction and Injury Prevention Coordinator with Saskatoon Health Region, another supporter of the new policy. “But now we realize that restraints can be considered a risk, and are not a safety device.”

To change the traditional way of thinking about restraints and their use will take everyone’s participation, but the team behind the new policy is certain it will affect the client experience in a positive way.

The Least Restraint policy was piloted in three acute care and long term care homes within the Region, and has now been rolled out for the entire Region. The revision took 18 months and included research and feedback from staff, clients, and families.

More information on the Least Restraint policy can be found at Saskatoon Health Region’s website.