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Restraint use in acute and critical care settings: changing practice
1Carolinas Medical Center, and Queens College, Charlotte, NC, USA. bmartin@carolina.rr.com
AACN Clinical Issues
|May 16, 2002
Summary
Reducing physical restraint use in acute and critical care requires addressing ethical, regulatory, and cultural factors. Successful programs involve understanding patient behavior, teamwork, and family involvement to decrease restraint practices.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety
- Nursing Practice
Background:
- Physical restraint use in acute and critical care settings presents significant ethical, legal, and professional challenges.
- Factors influencing restraint use include healthcare team attitudes, unit culture, and existing practice traditions.
Purpose of the Study:
- To explore the multifaceted issues surrounding the reduction of physical restraint use in acute and critical care.
- To identify key considerations for developing and implementing successful restraint reduction programs.
Main Methods:
- Review of ethical, regulatory, and legal considerations impacting restraint practices.
- Analysis of healthcare team factors, including knowledge, attitudes, and unit culture.
- Examination of process improvement models and specific intervention strategies for restraint reduction.
Main Results:
- Restraint reduction is complex, influenced by a wide range of factors from individual attitudes to organizational culture.
- Leadership support and a structured process improvement approach are crucial for program success.
- Interventions like understanding patient behavior, team collaboration, and family involvement are key components.
Conclusions:
- Decreasing physical restraint use necessitates a comprehensive understanding of supporting and opposing factors.
- Successful initiatives require a holistic approach integrating ethical, clinical, and cultural elements within acute and critical care settings.
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