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Planned change to implement a restraint reduction program.

M Gilbert1, C Counsell

  • 1Shands Hospital, University of Florida, Gainesville, USA.

Journal of Nursing Care Quality
|May 27, 1999
PubMed
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Reducing physical restraints in neurological units lowered patient falls and injuries. This shift also positively influenced nurses

Area of Science:

  • Neurology
  • Patient Safety
  • Nursing Practice

Background:

  • Physical restraints are a standard intervention for managing patient behaviors like agitation and interference with treatment in neurological units.
  • The use of restraints carries significant negative consequences, particularly for patients with neurological disorders or injuries.
  • A need exists to transition towards patient-focused, restraint-free care models.

Purpose of the Study:

  • To evaluate the impact of implementing a restraint-reduced environment in a neurological unit.
  • To assess changes in fall rates, fall-related injuries, and tube/line loss.
  • To examine staff nurses' perceptions of restraint use before and after the intervention.

Main Methods:

  • A convenience sample of adult patients admitted to a neurological unit was studied.

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  • Outcome data included fall rate, fall rate with injury, and tube/line loss.
  • Staff nurses' perceptions of restraints were measured using the Perception of Restraints Use Questionnaire (PRUQ) pre- and post-intervention.

    • Main Results:

    • The implementation of a restraint-reduced environment was associated with a decrease in fall rates, fall rates with injury, and tube/line loss.
    • Nurses' perceptions, assessed via the PRUQ, showed a trend towards reduced emphasis on restraints for managing patient behaviors.

    Conclusions:

    • A restraint-reduced model is supported by outcome data in neurological units.
    • This approach positively impacts patient safety indicators such as falls and injuries.
    • Reducing restraint use may also shift nursing perceptions towards less reliance on this intervention.