What are the legal/ethical requirements for using physical restraints on a hospitalized patient?

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Restraints are a safety measure that should be used only when there is a real risk of harm and no less restrictive option is appropriate. The use must be authorized by a clinician through an order, and the patient’s safety requires continuous monitoring, thorough documentation, and a plan to remove the restraint as soon as it is safe. When possible, consent should be obtained, and decisions should be guided by least restrictive means—trying de-escalation or other alternatives first.

This is why the best approach is to require a clinician’s order, ongoing monitoring, and careful documentation, with consent where possible and a commitment to using the least restrictive method. Restraints should not be routine for all agitated patients, nor should they be based on family consent alone or used for any reason as long as the patient remains in bed.