Restraint use post open heart surgery

[LLong08]

I work in a cardiovascular ICU in which restraint use post-operatively is routine until the patient is extubated. This practice has been done from the beginning and has never been questioned until now. Patient safety, satisfaction, and cost has never and is not an issue with the restraints. It prevents the patients from self-extubating or causing other self harm. Once extubation happens (usually within a couple hours post-op), restraints are removed. Now there is a push to go restraint free merely to improve hospital numbers.

I'm looking to hear from any nurses out there working with open heart surgery patients. Do you use restraints post-op or not? If not, what allows you to be restraint free? I want to know what works and what doesn't.

[cianogang]

I work in a CTICU and we do not regularly use restraints. We only restrain them in they wake up wild. Our incidence of self extubation is very very low

[springsong]

Cianogang,
In our post operative open heart cases, when patients are intubated and sedated we do not use restraints. Sedation is considered a chemical restraint. We use what we call freedom splint. If you search the internet you may be able to see it. Many hospitals are using this. I even saw it at the NTI being sold by one of the vendors. If the nurses feel that this does not work, soft wrist restraint is applied. A freedom splint is considered a noninvasive alternative measure and does not need the order of the physician.

[thompd]

Our hospital still uses soft wrist restraints for open heart patients post op routinely. I agree with you that the possibility of harm to the patient more than qualifies for physical restraints. I personally haven't tried any other way post operatively for CABG but I know I would be extremely nervous without the restraints. I am curious about the freedom splint product though and will research for possible change to our hospital. If it works for other hospitals its worth investigating but the change would probably come with much resistance from my coworkers - simply for fear of patient safety.