Restraint as a Last Resort

Informed Consent

Informed consent is required prior to all non-emergent restraint use. 

The health professional who is proposing the restraint or is in the best position to discuss the restraint requirement, is responsible for obtaining and charting voluntary and informed consent or refusal.

  • Candidly disclose all the facts which a reasonable person in the patient’s or SDM's position may be expected to consider before consenting to restraint.
  • Provide complete information on proposed restraint, including any known risks that are specific to the proposed restraint. 

Discussion to also include:

  • Which restraint alternatives have been unsuccessfully trialed
  • Reason restraint is being recommended (e.g. to administer IV therapy)
  • Type of restraint being recommended
  • Intended benefits
  • Risks of not using restraint
  • How often and how long the restraint will be used
  • How the medical condition will be affected
  • The right to refuse or accept the proposed restraint 
  • The right to withdraw consent at any time
  • Education about restraint as a last resort
  • Any known side effects, warnings, or risks of the restraint:
    • Risks of physical and environmental restraints: Refer to the user manual or product information sheets for risks that are specific to each product. Ensure a copy of same is accessible to all staff.
    • Risks of pharmacological restraints: Refer to the Micromedex® Care Notes® or Patient Medication Information on eCPS (RxTx) for risks, warnings, and side effects specific to each pharmacological restraint.


If the patient is capable of granting or withholding consent:

  • Only the patient may do so.

If the patient lacks legal capacity to make their own health care decisions:

  • Only the person with legal authority to provide or refuse informed consent on the patient's behalf while the patient is incapable, is able to do so.

See Nova Scotia Hospitals Act.

Document in the patient's chart:

  • A detailed summary of the information given and discussed, risks outlined, and questions answered
  • The outcome
  • Refusal of all non-emergent restraints

Continue to collaborate with the patient, their SDM and others involved in the patient’s Circle of Support for alternatives to restraints.