The nurse is reviewing documentation after restraints were used. What item from the documentation should be removed?

A: Documenting interventions used prior to the use of restraint is necessary to show that all other options were exhausted before resorting to restraints. B: Documenting least-restrictive measures used prior to the use of restraint is important to demonstrate that the least restrictive options were attempted first. C: Documenting the patient’s behavior that led to the use of restraint is crucial for justifying the use of restraints and for future care planning. D: The names of people the patient harmed during the violent episode should be removed to protect their privacy and confidentiality.