AONE believes that registered nurses with demonstrated competency in restraints should be allowed to certify the need for continued restraint. Many of our members currently have programs in place to demonstrate competency of their staff in the use of restraints as well as ongoing continuous quality improvement processes. We believe that registered nurses are responsible for the management and monitoring of patients and should be allowed to certify the need to continue restraints. We depend on nurses to use their judgement in every other clinical situation and restraint use should not be treated differently. An ongoing program of education, sharing and peer review needs to be developed to improve the consistency of both the consultation and site visit.
Nursing uses many methodologies inherently to avoid the use of restraints.
Restraint standards have increased documentation due to the need to document all least restrictive methodologies used. Communication with the Field AONE would urge the Task Force to suggest methods to improve communication with the field on new standards. There is a belief that the current communication vehicle, namely Perspectives, is not doing the job of informing the field about new standards. AONE members commented that they believe that the Restraint and Seclusion Standards were communicated to the field late and in an overly prescriptive manner. Use of restraints should be implemented by a registered nurse after an assessment.