e nurse is liable for any harm that can result from restraints that are inappropriately applied (Richman, 1998).In all cases, in which restraints are used, monitoring of patient needs is critical. The frequency of their monitoring is defined by organizational policy. Documentation is necessary to demonstrate compliance (Kobs, 1997). However, no studies have investigated if the documentation truly demonstrates compliance. As a matter of fact, it hasn't been an issue that has been addressed in the studies done on restraints. In a search of the literature there were no published studies concerning the reliability of documentation regarding restraints. Although the use of physical restraints has declined in nursing homes, the practice remains widespread in hospitals (Mion, 1996). Nursing staff (RNs, LPNs, and CNAs) from four hospitals completed a survey (Matthiesen, Lamb, McCann, Hollinger-Smith and Walton, 1996) regarding knowledge, practice, and attitudes about physical restraints. Nurses from both geriatric and geropsychiatric units reported significantly more educational activities about restraint use than did nurses on medical units. Overall, there have been few studies that address hospital physical restraints. However, public awareness of the use of restraints in hospitals has been greatly heightened due to the recent debates about the needs for national standards in Congress (Annas, 1999). New federal regulations were announced in July 1999 which apply to all patients in hospitals that participate in the Medicare and Medicaid programs (Annas, 1999). With heightened Patient Restraint5public awareness, hospitals need to be much more aware of how their policies and protocols are being implemented if they wish to avoid being held liable for not following the federal regulations on restraints. The goals for a planned change project should include improving nursing education among medical-surgical nursing staff; evaluating kno...
