Restraint and Seclusion - Enclosure Beds, Side Rails and Mitts

Is an enclosure bed, side rails, or hand mitts a restraint?

Any examples are for illustrative purposes only.

Enclosure Bed/Side Rails
The determination as to whether or not side rails would be considered a restraint is based on “intent.”  Therefore:
  • if the intent of raising the side rails is to prevent a patient from voluntarily getting out of bed or attempting to exit the bed, the side rails would be considered a restraint.
  • If the intent of raising the rails is to prevent the patient from inadvertently falling out of bed, then it is not considered a restraint.  Also, if a patient does not have the physical capacity to get out of bed regardless if side rails are raised or not, then the use of side rails is not considered a restraint.
Use of an enclosure bed or net bed that prevents the patient from freely exiting the bed is considered a restraint.  An exception is the use of an enclosed crib for infants and/or toddlers.

Hand Mitts
Hand mitts would be considered a restraint if:
1) The mitts are pinned or otherwise attached to the bed/bedding or wrist restraints are used in conjunction, and/or
2) The mitts are applied so tightly that the patient's hands or finger are immobilized, and/or
3) The mitts are so bulky that the patient's ability to use their hands is significantly reduced, and/or
4) The mitts cannot be easily removed intentionally by the patient in the same manner it was applied by staff considering the patient's physical condition and ability to accomplish the objective.

If the mitts meet any of the above criteria, it would be considered a restraint.
Last updated on March 04, 2021
Manual: Critical Access Hospital
Chapter: Provision of Care Treatment and Services PC

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