The vest restraint is mostly for elderly patients who are likely to attempt to get out of bed but are not constantly trying to do so. The proper application for most brands requires putting it on like donning a clothing vest and crisscrossing the ends at the front. The nurse then ties the straps together under the bed. All nursing personnel learn two overriding principles. Vest restraints are dangerous when not applied correctly or when used as a substitute for patient monitoring.
I have recently reviewed one case from the Southwest in which a nurse found an elderly male patient strangled in a vest restraint. The vest was on backward, which brought the neckline up to the patient's throat. The poor soul, while trying to wriggle out of it, virtually hanged himself. In many other cases, unmonitored patients had fallen on the floor or had wandered off while the vest remained on the bed still tied.