Research-based practice: reducing restraints in an acute care setting--phase I

Area of Science:

• Nursing Research
• Healthcare Quality Improvement
• Patient Safety

Background:

• Physical restraints are used in acute care settings, necessitating strategies to reduce their application.
• Staff perceptions regarding the importance of restraints influence their utilization.
• Evidence-based education is crucial for modifying clinical practice and improving patient care outcomes.

Purpose of the Study:

• To implement a research-based Restraint Education Program in an acute care setting.
• To decrease the use of physical restraints by altering restraint coordinators' perceptions of their importance.
• To utilize the Iowa Model for guiding the research utilization and change process.

Main Methods:

• A multidisciplinary team reviewed restraint policies, products, and alternatives.
• The Strumpf and Evans Restraint Education Program was selected and adapted.
• A pilot study involved administering the Perceptions of Restraint Use Questionnaire (PRUQ) pre- and post-education to restraint coordinators.

Main Results:

• Post-education testing showed a decrease in mean scores on 7 of 17 PRUQ items, indicating reduced perceived importance of restraints.
• Four PRUQ items showed an increase in mean scores, suggesting a heightened perception of importance for specific restraint uses.
• The education program was subsequently rolled out to all nursing staff institution-wide.

Conclusions:

• Education is a key component in decreasing the use of physical restraints.
• The Restraint Education Program demonstrated potential in shifting staff perceptions, though varied responses were noted.
• Ongoing monitoring by risk management and quality assurance will evaluate the program's sustained impact on restraint use and staff perceptions.