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Intention to use physical restraint in paediatric intensive care units and correlated variables: A multicentre and
Alejandro Bosch Alcaraz1, Jesús Corrionero Alegre2, Sonia Gil Domínguez3
1Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain.
Insights
Paediatric Intensive Care Unit nurses show moderate intention to use physical restraint (PR), influenced by patient anxiety and employment factors. Understanding these influences is key to standardizing safe practices and respecting patient rights.
Area of Science:
- Nursing
- Pediatric Critical Care
- Patient Safety
Background:
- Physical restraint (PR) is utilized in pediatric intensive care units (PICUs).
- Factors influencing nurses' intention to use PR require further investigation.
Purpose of the Study:
- To determine the intention to use physical restraint (PR) among PICU nurses.
- To explore the relationship between PR intention and sociodemographic/professional variables.
Main Methods:
- A multicentre, correlational study was conducted in five Spanish PICUs.
- The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire was used.
- Sociodemographic and employment data were collected from 230 nurses.
Main Results:
- Nurses reported moderate intention to use PR (mean score 28.0 ± 6.0).
- PR use was higher for anxious patients, those with low sedation, withdrawal symptoms, or high risk of device removal/falls.
- Female sex and employment contract type significantly correlated with PR intention.
Conclusions:
- PICU nurses demonstrated moderate attitude, subjective norms, and perceived behavioral control regarding PR.
- Identifying factors influencing PR intention is crucial for standardizing safe practices and respecting pediatric patients' rights.
Objectives:
To determine the intention to use physical restraint (PR) and the relationship with sociodemographic and professional variables of the Paediatric Intensive Care Unit (PICU) nurses.
Research Methodology/Design And Setting:
A multicentre and correlational study was carried out from October 2021 to December 2023 in five paediatric intensive care units from five maternal and child hospitals in Spain. The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire was provided. Moreover, sociodemographic and employment variables were registered.
Results:
A total of 230 paediatric nurses participated in the study. A total of 87.7 % were females with an average age of 35.5 ± 9.7 years and working experience of 10.5 ± 8.4 years. The mean scores obtained were 21.1 ± 3.8 for attitude, 13.1 ± 5.0 for subjective norms, 14.4 ± 4.3 for perceived behavioural control and 28.0 ± 6.0 for intention. The nurses apply more physical restraint to anxious patients, with scarce analgesics and sedation, those affected with pharmacological withdrawal symptoms and those with a high risk of accidental removal of vital support devices or fall from bed. The sex (p = 0.007) and type of employment contract (p = 0.01) are the variables that are significantly correlated with the intention to use of PR.
Conclusion:
The paediatric nurses analysed had a moderate attitude, social pressure and perceived behavioural control towards the use of PR.
Implications For Clinical Practice:
It is important to know the factors that influence the intention to use physical restraint in order to standardise safe practice for critically ill paediatric and to ensure that patients' rights are respected by obtaining informed consent and assessing the prescription, continuation and removal of physical restraint.
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