A systematic overview of interventions to reduce physical restraint use in long-term care settings

The purpose of this systematic integrative review was to summarize the empirical evidence regarding the effectiveness of interventions or programs to reduce physical restraint use in long-term care facilities.

Research findings indicate that physical restraint reduction programs which included an educational component, restraint removal, and interventions individualized to residents' specific needs were successful in decreasing restraint use. There were no significant negative consequences for residents or staff associated with the implementation of restraint reduction programs or interventions. Educational programs had a positive impact on nurses' knowledge, attitudes, and practices regarding restraint use. Findings, however, must be considered in light of the methodological weaknesses noted in the studies.

The practice goal of achieving least-restraint or restraint-free long-term care facilities is an appropriate and achievable one. This objective can be facilitated through ongoing mandatory educational programs for staff, individualized assessment and implementation of appropriate interventions for residents, and adequate administrative support. Well-designed research studies investigating the efficacy of specific interventions, cross-cultural issues, and longitudinal outcomes would all contribute to the further development of evidence-based practice regarding restraint use in long-term care facilities.