Patient restraints: new guidelines for a less restrictive approach.

Restraints, both mechanical and pharmacologic, have been overused in hospitals and nursing homes in the United States. Recently, a fundamental change in attitude of the health care team from a paternalistic, institution-centered mode to one that centers on the needs of the patient has led to a less restrictive approach. Typically, restraints have been used to prevent falls or wandering, to control agitation, and to protect medical devices. Before using any form of restraint, however, the physician should consider management alternatives, based on a careful consideration of the patient's problems.