Alberta Health Services is committed to the safety of patients, clients, staff and volunteers.

The objectives of the Restraint as a Last Resort policy are to:

• provide direction based on the principles of restraint as a last resort and the least restrictive restraint
• promote consistency in decision-making processes
• support a balance between the safety of patients and others, and restrictions on patient liberty

The Restraint as a Last Resort policy includes pharmacological, mechanical, physical and environmental restraints.

Except in emergencies, restraint will only be used when all other strategies, have been deemed ineffective or inappropriate. In all patient encounters, care teams shall work with patients and/or alternate decision-makers to use restraint as the last resort.

• Policy
• Procedure
• Consent Policy Resources for Practitioners
• Restraint Audit Tool
• FAQ

• Inpatient Mechanical Restraint Monitoring Record
• Emergency/Urgent Care Patient Restraint Monitoring Record
• Pharmacologic Restraint Management Worksheet
• Observation Record (Form 20909 - sample only)
• Getting to Know You
• Agitated Behaviour Mapping Tool (Form 19626)
• Behaviour Mapping Chart
  • Guide
  • Process
  • Presentation Notes | Slides
• Comfort Rounds
  • Comfort Rounds Bedside Care Record (Form 18649)
  • Comfort Rounds Documentation (Form 19834)
  • Comfort Rounds Documentation (Form 20233)

• Posters: Physical, Environmental, Pharmacologic, Mechanical
• Restraint as a Last Resort in Acute Care: Are you ready?
  • Slides
  • Notes
  • Worksheet
• Legacy vs Provincial Policy Comparison
• Trauma Informed Care
• Workplace Harassment and Violence Prevention
  • Safe Care, Together 
• College & Association of Registered Nurses of Alberta
• Registered Nurses Association of Ontario
  • RNAO: Best Practice Guidelines: Assessment, Prevention, Alternative Approaches

• Information for Prescribing Practitioners
• Information for Prescribing Practitioners working with older adults
• Case Study: Consent for Restraint as a Last Resort
• 7 Keys to Reduce Restraint Use
• Treating Disruptive Behaviours in Dementia

• Restraint as a Last Resort in the Context of OT and PT Practice
• Mechanical Restraint vs Positioning Devices Clinical Decision-making Algorithm
• Adult Allied Health Clinical Scenarios
• Pediatric Allied Health Clinical Scenarios

Addiction & Mental Health

• Information to Consider When Restraint is used in Addictions and Mental Health - Inpatient
• Resources to Prevent and Debrief Behavioural Emergencies
  • Staff Debriefing Tool
  • Patient Debriefing Tool
  • 10 Domains of De-escalation
• For additional resources see AMH Policy Resources on Insite

Critical Care

• Causes of Agitated Behaviour
• Monitoring and Documentation Requirements

Emergency

• Emergency/Urgent Care Patient Restraint Monitoring Record (Form 101593)
• Resources on Proper Application of Restraint
• eLearning module available on MyLearningLink and CliC (Covenant Health)

Inpatient Adults

• Alternate Inventions to Restraint
• Information to Consider when Restraint is Used
• Elder Friendly Toolkit
  • Restraint as a Last Resort - Older Adults in Acute Care
• Use of Least Restrictive Restraint - Restraint Algorithm

Inpatient Pediatrics

• Alternative Methods/Interventions to Restraint Use
• Information to Consider When Restraint is Used
• Pediatric Frequently Asked Questions
• Restraint as a Last Resort in Pediatrics presentation
• Pediatric eLearning module available on MyLearningLink

Older Adults

• Appropriate use of AntipsychoticsToolkit
  • Curbside Consultations
• Elder Friendly Care Toolkit
  • Restraint as a Last Resort for Older Adults in Acute Care, Elder Friendly Care
• Responsive Behaviour Tracking and Assessment Tool
• Continuing Care Health Service Standards
  • For additional resources, see the Continuing Care Connections and/or Seniors Health Provincial: Clinical Practice Development on Insite
• Seniors Health Strategic Clinical Network

Protective Services

• Additional resources for AHS staff are available on Insite

Rehabilitation/Acquired Brain Injury

• Alternative Interventions to Restraint Use in Adult Patients
• Management of Agitation Following Brain Injury - Rehabilitation and Acquired Brain Injury - Adult Patients
• Monitoring Checks of Mechanically Restrained Adult Patients