Nurses Practice and Influencing Factors regarding Physical Restraint use in the Intensive Care Units in Northwest Ethiopia

Abstract

Background: Physical restraint is a common clinical practice in intensive care units. Even though physical restraint is used to prevent the removal of life support tubes and risk of a patient’s falling injure; complications such as edema, laceration, and pain at the restrained site, restricted circulation, worsening of agitation or delirium that may end with death are frequently encountered. Despite the sensitivity of the problem, there are gaps in nurses’ evidence-based practice in Ethiopia. Before developing protocols and guidelines relevant evidence-based practices of nurses are required. So, this study aimed to assess the practice and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff Regarding Physical Restraints Questionnaire was used to assess the nurses’ knowledge, attitude, and practice. Linear regression analysis was computed to examine the influencing factors of nurses' practice. An adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used to report the result of association. Statistical significance was declared at p-value<0.05. Result: The mean score of the nurses’ practice regarding physical restraint use among critically ill patients was 30.94±5.44. This mean score is above the scale midpoint nearer to the higher range that implies the majority of nurses have a satisfactory practice regarding physical restraint. Less than or equal to 2 years of work experience [β= -1.34, 95% CI (-2.47, -0.21)] was significantly associated with poor nurses practice; received training regarding restraints [β= 1.49, 95% CI (0.16, 2.82)], higher level of knowledge [β=0.40, 95% CI (0.03, 0.78)] and better attitude scores [β=0.37, 95% CI (0.27, 0.47)] were associated with good nurses practice regarding physical restraint use.Conclusion: Nurses working in the intensive care units had a satisfactory practice regarding physical restraint use on critically ill patients. So developing and providing educational and in-service training to the nurses on the alternative strategies, complications, and risks of physical restraint are important to strengthening the quality of nursing care for critically ill patients.