Development and Validation of Clinical Practice Standards for Physical Restraint in Hospitalized Patients: A...

Physical restraint is commonly used in clinical settings to ensure patient safety, yet its application lacks standardization and may lead to adverse physical and psychological effects. There remains a significant gap in evidence-based guidelines tailored to nurses practices.

This study aimed to develop and validate clinical practice standards for physical restraint in hospitalized patients from a nurses staff perspective and to evaluate their impact on nurses knowledge, attitude, behaviors, and patient outcomes.

A multi-stage design was employed, including a cross-sectional survey, semi-structured interviews, a Delphi expert consultation, and a controlled trial. The study involved 202 nurses and 100 patients from a tertiary hospital in Chongqing, China. The intervention group received standardized training based on the newly developed restraint criteria, while the control group followed routine protocols.

The expert consultation achieved high consensus (Cr = 0.85). Post-training, the intervention group showed significant improvements in knowledge, attitude, and practice scores (P < 0.05), and a reduction in restraint use and duration (P < 0.05). Although adverse event rates decreased in the intervention group, the differences were not statistically significant.

The developed standards effectively enhance nurses practice, reduce unnecessary restraint use, and maintain patient safety, supporting their integration into clinical nurses management.