Physical restraint use in acute care settings

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Nursing Practice

Background:

• Physical restraint devices are increasingly used in hospitals.
• Restraint use is a significant quality improvement issue in acute care.
• Potential drivers for increased restraint use include litigation concerns.

Purpose of the Study:

• To review existing studies on physical restraint devices in acute care.
• To explore the decision-making processes of nurses regarding restraint use.
• To identify factors influencing the application and removal of mechanical restraints.

Main Methods:

• A comprehensive literature review of studies on physical restraints in acute care settings.
• A descriptive study incorporating focus groups with nurses.
• Exploration of the nursing decision-making process for initiating and discontinuing restraint use.

Main Results:

• The review synthesized findings from various studies on restraint devices.
• Focus groups provided insights into the complex decision-making involved in patient restraint.
• Nurses' rationale for applying and releasing mechanical restraints was elucidated.

Conclusions:

• Physical restraint use in hospitals necessitates a focus on quality improvement.
• Understanding nurses' decision-making is crucial for optimizing restraint protocols.
• Further research may inform best practices for minimizing unnecessary restraint in acute care settings.