Nurse education to reduce physical restraints use in ICU: A scoping review

Physical restraints are defined as a manual approach to reduce a patient's physical movement and has been regarded as a protective nursing measure in the intensive care unit (ICU) to avoid unplanned extubation, falls, and other unexpected events. However, the limitations and changes associated with physical restraints have been verified by several studies. Restraint minimization has been advocated by studies worldwide; however, the most effective interventions are still being explored.

To identify and map nurse education strategies that reduce the use of physical restraints in the ICU.

A systematic literature search that followed the steps of a scoping review was performed in the Cochrane, PubMed, Embase, CINAHL, CNKI, Wan Fang Data, and VIP databases. We included studies that focused on nurse education aiming to reduce the use of physical restraints and/or use physical restraints reasonably.

The included studies (n = 12) described a variety of education strategies. Two delivery modes, eight common course durations, 14 main topics, two types of teaching methods with various materials, and two kinds of outcome measurements were identified and compared.

There are a variety of nurse education activities that could effectively improve ICU nurses' knowledge, attitudes, and behaviours towards physical restraints. However, the strategies of nurse education, such as delivery mode, teaching methods, and outcome measurements, require further study.

Nurse education on physical restraints should be carried out in ICUs. Online courses, practical sessions, and simulated scenarios should be a part of future nurse education. In addition to nurses' knowledge and attitude changes, frequency of physical restraints and other patient-related outcomes should also be considered for outcome evaluation.