Overview
The Threshold: Prevent Serious Bodily Harm, Not Convenience
A restraint is a device, manual hold, medication, or environmental restriction that limits a person’s freedom of movement.
A restraint is a device, manual hold, medication, or environmental restriction that limits a person’s freedom of movement. Canadian nursing regulators commonly describe three categories: - Physical restraint: a device or manual method that restricts movement, such as a belt, limb device, mitt, or manual hold. - Chemical restraint: a psychoactive medication given primarily to control behaviour rather than to treat a diagnosed condition. - Environmental restraint: confinement that limits movement, such as seclusion, a locked area, or a locked unit in circumstances where the person cannot leave. The governing principle is least restraint. Restraint is justified only as a last resort when there is a serious threat of bodily harm to the patient or another person, and prevention, de-escalation, and other crisis-management strategies have been attempted without success. Staff convenience, lack of observers, a busy unit, punishment, or routine fall prevention is not a valid indication. The legal standard also requires proportionality: use the minimum force or restriction reasonably necessary for the patient’s physical and mental condition. The goal is not to make a difficult patient easier to manage....