1. Mental Health Champions June 2014
Pinel Restraints Basic Operations and Cuff Restraints (This module requires sound and video)
Mental Health Champions
June 2014

2. Learning Objectives Understand the criteria for Pinel restraints
Identify where to locate Restraints
Learn how the restraints are accessed
Recognize the importance of the key location while Pinels are in use.
Be able to demonstrate proper cuff application
Understand how to lock and de-lock the restraints

3. Why Use Pinel Restraints
Pinel restraints are capable of securing patients with a variety of restraint levels and limitations Simple and quick adjustments allow you to change the restraint level in order to adjust to a patient’s changing needs and condition. The intent is to secure as necessary, but with the patient’s maximum comfort in mind.

4. Least Restraint
All restraints should be……..
Used for a brief period of time
Used only if alternative measures are ineffective
Used when there is imminent risk of harm to self or others
Restraints should always be considered as a last resort
As per Headwaters Least Restraint Policy

5. Staff must know the limits of these restraints
Restraining someone is an unnatural act that can be dangerous to both staff and patient
Staff must know the limits of these restraints

6. Criteria for Restraint Use
Pinel Restraints are used
To prevent serious bodily harm to the patient, staff or others
To promote greater freedom for patients in crisis while maintaining safety of the patient and staff
When a restraint is deemed necessary in an individualized care plan and consented to by the patient and/or substitute decision maker

7. Location of Pinel Restraints
Headwaters has 3 sets of Pinel restraints located:
In the trauma room (set up for bed 12)
In the emergency department (back of the nursing station)
In the critical care unit (far left under the nursing station desk)
All restraints MUST be signed out before taking them to your unit.

8. Sign out Log The sign out log sheet will be found in the duo tang beside the bag.

9. De-locking Key
All keys are found within the Pinel bag on a colourful lanyard
The key should NEVER be kept on your person as it should be readily available to all staff in an emergency situation.
Keys kept in your pocket can travel with you to other units, the bathroom, the cafeteria…….

10. WHEN THE RESTRAINT IS IN USE
Where does the key go?
Once the restraints are applied the key MUST be placed in the medication room on the designated sign (see image on left)
This ensures a consistent KEY location on all units.
A spare key will always be kept in the 2 unit Managers offices, as well as the off shift supervisor and security.
WHEN THE RESTRAINT IS IN USE
HANG KEY HERE
Pinel Restraint Key

11. Cuff Application Initially aim for speed rather than accuracy
Apply Velcro to the limb (wrist or ankle) on an evenly distributed angle
Place the black portion over the limb, then the white
BLACK first then WHITE
Once the patient is secured, use help to accurately adjust the cuff to ensure the ideal angle is achieved. At this time with assistance remove any objects from underneath the cuff (clothing, watches, bracelets etc.)

12. Please refer to Headwaters Levels of Observation Standards
Ensure the patient’s comfort by assessing and documenting the colour, sensation and movement of the limb hourly
Please refer to Headwaters Levels of Observation Standards

13. Remember BLACK first then WHITE

14. Securing to Stretcher or Bed
Ensure the restraint system is secured to a section of the stretcher or bed that will not adjust the tightness for the patient when the height is adjusted
Do not attach to the side rails or base of the bed

15. Locking
A steel pin is inserted through the grommet holes of the material and held together to a maximum of 4 layers of material
Insert the black locking button onto the top of the pin
Tug on the button to ensure engagement (listen for a click)
Materials are now locked together with a force of approximately 800 pounds

16. De-locking
The button cannot be removed until all the pressure is released from underneath
Insert the magnetic key on top of the button
Remove the button by lifting both the button and the key "not just the key.”

17. Cleaning and Restocking Process
When Pinel restraints are discontinued….
Please call the Multi-skilled Worker (MSW) in the Emergency Department to arrange pick up of the Pinel system at extension 2983
from 11:00am– 01:00am.
Help us ensure the system is available the next time you need it

18. Have you had your hands on training?
This module is used in conjunction with hands on training. If you have not had hands on training in the following skills
Locking
De locking
Cuff restraints
Safety
Please connect with one of the Mental Health Champions
Tammy Brady - D wing ex 3230
Joe Karol - F wing ex 2239
Lori Recoskie – Emergency ex 2214

19. Video Review Please review the two videos included with this module
Basic Operations – 4 minutes
Cuff Restraints – 3 minutes
These videos require sound

20. References
Pinel website The Mental Health Act 2012 Quality Health Network - Road to Least Restrain Policy College of Nurses – Practice Standards – Restraints Headwaters Least Restraint Policy Headwaters Levels of Observation Standard of Care