Healthcare staff's experiences of using manual physical restraint: A meta‐synthesis review

Abstract

Manual restraint is a hands‐on type of physical restraint used to prevent harm to service users and staff, and to administer necessary treatments. This article reports on a review and meta‐synthesis of the qualitative literature on healthcare staff's experiences of using manual restraint. Three electronic databases (CINAHL Complete, MEDLINE, and PsycINFO) were systematically searched, and 19 studies were included. Thematic synthesis was used to synthesize the findings. The Critical Appraisal Skills Programme (CASP) checklist was used to appraise study quality. The synthesis generated one overarching interpretive theme, “unpleasant but necessary,” and five subthemes: “maintaining safety triumphs all,” “emotional distress,” “significance of coping,” “feeling conflicted,” and “depletion.” Seven studies indicated that, from staff perspectives, manual restraint was not always used as a last resort. Healthcare staff experience manual restraint as a psychologically and physically unpleasant practice, yet paradoxically deem its use to be sometimes necessary to keep themselves and service users safe from harm. The findings indicate a need for healthcare staff support, post‐restraint debriefing meetings with service users, and the implementation of manual restraint minimization programs in healthcare settings.

Moral Dilemmas Regarding Physical Restraints in Intensive Care Units: Understanding Autonomy, Beneficence, Non-Maleficence and Justice in the Use of Physical Restraints

“…Some studies have focused on factors that influence the moral issue of nurses, as well as experiences of physical restraints. 9 , 10 These studies indicate that even if nurses guide physical restraints as necessary, they still face moral issue. Therefore, this paper examines the use of physical restraints in medical settings through the four universal principles of ethics of autonomy, beneficence, non-maleficence and justice to help the nursing profession.…”