Implementation of a Physical Restraint Decision Tree on Reducing Physical Restraint Use in an Adult Intensive Care
1Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Journal of Clinical Nursing
|July 23, 2026
Summary
A new decision tool significantly reduced physical restraint (PR) use in ICUs, improving patient outcomes and lowering costs. Nurses reported high satisfaction with this evidence-based approach to patient care.
Area of Science:
- Critical Care Medicine
- Nursing Practice
- Healthcare Management
Background:
- Physical restraint (PR) use in intensive care units (ICUs) can lead to adverse patient outcomes.
- Minimizing PR use while maintaining patient safety is a critical challenge in ICU care.
Purpose of the Study:
- To develop and evaluate a decision tool to minimize PR use in adult ICUs.
- To assess the impact of the tool on patient outcomes and nurse satisfaction.
Main Methods:
- Mixed-method design including a Delphi study for tool development (PRDT).
- Quasi-experimental study to evaluate PRDT effectiveness in an ICU.
- Qualitative interviews to explore nurses' perspectives on PRDT implementation.
Main Results:
- PR rate decreased from 48.1% to 10.1% after PRDT implementation.
- Average ICU length of stay reduced, and daily costs decreased.
- No increase in adverse events; nurses reported high satisfaction with the PRDT.
Conclusions:
- The PRDT offers a structured, evidence-based method for reducing PR use in ICUs.
- Implementing the PRDT leads to significant reductions in PR use without compromising patient safety.
- The PRDT can standardize ICU practices and align care with best practice guidelines.
