SCRMC Patient Safety Module

The table below shows the practice differences
between medical-surgical restraints and those used
for behavior control.
Requirement Medical-Surgical Restraint Behavior Control Restraint
Physician’s Order
Order must include
Time Limitation
Initiation
Requires a physician’s order
which must be obtained within
12 hours of application
Purpose of the restraint, time limit, type
of restraint, and clinical indications.
Medical-surgical healing restraints are
limited to 24 hours without a physician
re-ordering the restraint
Medical-surgical restraints may be
initiated by a RN based on patient
assessment
Physician Notification The physician must be notified within 12
hours of the initiation and a verbal or
written order is obtained. If the
restraints are based on a significant
change in the patient’s condition, the
physician is immediately notified.
Physician Assessment
Monitoring of the Patient by
Nurses
Documentation
The patient must be evaluated by a
physician within 24 hours
These patients are observed by the
nurse every 2 hours
Monitoring is documented every 2 hours
in the medical record
Requires a physician’s order
which must be obtained within
one hour of application
Purpose of the restraint, time
limit, type, and clinical
indications
Behavior -control restraints
are limited to 4 hours. After 4
hours the restraints must be
removed or re-ordered
Only trained clinical staff may
initiate behavior-control
restraints
The physician is notified as
soon as possible but no longer
than one hour after the
initiation of the restraint.
The physician must do a faceto-face
evaluation of the
patient within one hour
Must be continuously
monitored by one-on-one
observation
Monitoring is documented
every 15 minutes
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