The advanced practice nurse and changing perspectives on physical restraint

Area of Science:

• Nursing and Healthcare Policy
• Patient Safety and Clinical Practice

Background:

• Nursing home regulatory changes prompt review of physical restraint use in hospitals.
• Conflicting messages and legal ambiguities surround hospital restraint practices.
• Restraint use presents ethical dilemmas between patient autonomy and best interests.

Purpose of the Study:

• To examine current restraint use practices in acute care settings.
• To evaluate the effectiveness and consequences of physical restraints.
• To identify strategies for successful restraint reduction in hospitals.

Main Methods:

• Review of recent research on physical restraint efficacy and adverse effects.
• Analysis of legal implications and ethical considerations in restraint decision-making.
• Examination of successful restraint reduction strategies from nursing homes.

Main Results:

• Current evidence does not support the belief that restraints prevent patient injuries.
• Research continues to document negative effects associated with physical restraint use.
• Restraint reduction initiatives have proven effective in nursing home settings.

Conclusions:

• Strategies for restraint reduction in nursing homes can be adapted for acute care.
• Interinstitutional collaboration is essential for consistent restraint reduction across care settings.
• Advanced practice nurses play a crucial role in facilitating continuity of restraint reduction efforts.