Physical, chemical, and environmental restraints have historically been considered appropriate benevolent measures that are implemented in order to protect individuals from injury. Little consideration regarding autonomy or quality of life was given to this practice, which current research indicates is both mentally and physically punishing. Restraint use was an automatic response to prevent injury regardless of possible consequences. A multidisciplinary team of health care providers at our organization recognized the multiple adverse consequences of restraining people and took measures to alter the internal culture of our organization, reduce the overall use of restraints, and promote patient autonomy, safety & dignity in relation to restraint use. Strong organizational least restraint philosophy, systems that support effective communication between team members, multidisciplinary front-line staff restraint resources, and ongoing education were identified and implemented as least restraint enablers. All of these enablers collectively work together to create an environment that promotes person-centred least restraint success stories. Sharing success stories among front-line staff has resulted in a cyclical process that facilitates least restraint education, highlights day to day progress and demonstrates our collective journey from discussion to action. These efforts have been ongoing and require assistance from all levels of hospital staff. A great deal of work lies ahead and our goal to promote quality of life and human dignity while providing a safe environment will be met when alternatives to the use of restraints becomes a day to day objective. The recognition of the collaborative efforts required to promote this kind of change in an organization has empowered our team to begin to alter the existing culture to one that supports least restraint philosophy.
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