LibGuides: Restraint as a Last Resort: Obtain Informed Consent

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.

Restraint Considerations for Patients and Families
Nova Scotia Health Patient Pamphlet

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.

Micromedex Solutions This link opens in a new window
Micromedex has 2,500+ comprehensive drug monographs, organized in quick answer or in-depth format, allowing users to explore current, evidence-based information about medications. This includes dosing, FDA and non-FDA (off-label) uses, and safety information. Micromedex also provides crucial functions to support patient safety, such as IV compatibility, drug interactions, drug identification, drug comparison, and a suite of 650+ clinical calculators.
CPS (formerly RxTx) This link opens in a new window
The Canadian standard for drug monographs. Contains information on thousands of products, including: monographs for drugs, vaccines, natural health products and medical devices (approved by Health Canada); Lexi-Interact drug interaction checker within CPS; critical updates (warnings, advisories and drug shortages); tools, including medical calculators, Clin-Info, Pill Identifier and more. Updated twice per month by the Canadian Pharmacists Association.

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.