Prevalence and Variation of Physical Restraint Use in Acute Care Settings in the US

Minnick, Ann F.; Mion, Lorraine C.; Johnson, Mary E.; Catrambone, Cathy; Leipzig, Rosanne M.

doi:10.1111/j.1547-5069.2007.00140.x

Cited by 132 publications

(159 citation statements)

References 28 publications

(32 reference statements)

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“…Conversely, the rate of using of PR is different based on patients' age category. For instance, patients were restrained at rates of 6% to 13%, while patients aged 65 years or older were restrained at a higher rate (18% to 22%) [3]. Similarly, Tinetti et al [7] found patients' characteristics such as disorientation, dependence on getting dressed and the use of antidepressants to be independently associated to rate of using restraints.…”

Section: Introductionmentioning

confidence: 99%

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Improving ICU Nurses’ Practices of Physical Restraints in Jordan: Effect of an Educational Program

Nasrate¹,

Shamlawi²,

Darawad³

2017

Health

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Background: Physical Restraint (PR) has been widely used in the intensive care units, which aims to protect patients and maintain their safety. With all benefits of PR, there are many complications and risks from improper utilization. Further, no Jordanian studies have found to educate nurses regarding the proper PR utilization. Purpose: To evaluate the impact of an educational program on nurses' knowledge, attitude and practice regarding PR use in ICUs. Methods: A pre-experiment with one-group pretest-posttest design was used among 40 ICU nurses. A self-administered questionnaire was used to evaluate nurses before the education program and two weeks after its completion. Results: After implementation of the program, nurses demonstrated a significant difference in knowledge scores between pretest (M = 10.35 ± 1.73) and posttest (M = 13.30 ± 1.47) (t = 9.92; df = 39; P = 0.000), attitudes scores (M = 27.90 ± 2.79 vs. M = 30.40 ± 2.32) (t = 4.61; df = 39; P = 0.000), and practice scores (M = 36.85 ± 1.98 vs. M = 40.52 ± 1.60) (t = 11.59; df = 39; P = 0.000). Conclusion: Service-education program can improve ICU nurses' knowledge, and enhance their attitudes and practices towards physical restraint. Such improvement is expected to be reflected in improving the quality of care delivered to the patients, and decreasing complications of malpractice regarding physical restraint.

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Section: Introductionmentioning

confidence: 99%

“…PRs are used in intensive care units (ICU) rather than other wards due to confusion and agitation of the patients that affect on their safety and risk for falling in the ICU [3]. In addition, a recent study reported major reasons for restraints includes "Behavioural/confused/violent" (65%) and preventing falls (62%) [4].…”

Section: Introductionmentioning

confidence: 99%

Improving ICU Nurses’ Practices of Physical Restraints in Jordan: Effect of an Educational Program

Nasrate¹,

Shamlawi²,

Darawad³

2017

Health

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“…The scope of the use of physical restraint is still unclear; however; frequencies between 0% and 100% have been reported. 2,[10][11][12][13] In previous studies, 2,10 the frequency of physical restraint was estimated by using surveys, a method that may be subject to bias. In observational studies [11][12][13][14] in which patients were individually examined, few different centers or ICUs were included.…”

mentioning

confidence: 99%

“…2,[10][11][12][13] In previous studies, 2,10 the frequency of physical restraint was estimated by using surveys, a method that may be subject to bias. In observational studies [11][12][13][14] in which patients were individually examined, few different centers or ICUs were included. A recent French investigation 10 indicated that in 82% of ICUs, physical restraint was used at least once during mechanical ventilation in more than 50% of the patients.…”

mentioning

confidence: 99%

Use of Physical Restraints in Dutch Intensive Care Units: A Prospective Multicenter Study

Kooi

Peelen

Raijmakers

et al. 2015

American Journal of Critical Care

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Background Increasing evidence indicates that harmful effects are associated with the use of physical restraint. Objectives To characterize the use of physical restraint in intensive care units. Prevalence, adherence to protocols, and correlates of the use of physical restraint were determined. For comparisons between ICUs, adjustments were made for differences in patients' characteristics. Methods A prospective, cross-sectional, observational multicenter study with a representative sample (n = 25) of all Dutch intensive care units, ranging from local hospitals to academic centers. Each unit was visited twice, and all 379 patients admitted during these visits were included and were examined for use of physical restraint. Results Physical restraint was used in 23% of all patients (range, 0%-56% for different units). Of all 346 nurses interviewed, 31% reported using a protocol when applying physical restraint. When corrections were made for clustering within units, the risk for use of physical restraint was increased in patients with delirium or coma, in patients who could not communicate verbally, and in patients receiving psychoactive or sedative medications. Sex, severity of illness, and nurse to patient ratio were not independently related to use of physical restraint. In 11 units (44%), use of physical restraint was more frequent than expected on the basis of patients' characteristics, although this finding was not significant. Conclusions Physical restraint is frequently used in Dutch intensive care units. The differences in frequency between units suggest that opportunities exist to limit the use of physical restraint.

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“…The few studies about their use in hospitals indicate prevalence rates ranging from 3.4% to 18.5%, with restraints applied more frequently on adults aged 65 or older [4]. To search for reports on the prevalence of physical restraint use in rehabilitation settings, a literature search was conducted.…”

Section: Introductionmentioning

confidence: 99%

Use of Physical Restraints in a Rehabilitation Setting: Findings from a Point Prevalence Survey

Lai¹

2015

J Nurs Care

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A point prevalence survey among 125 patients in two units of a rehabilitation facility showed that the physical restraint rate was 12.8% (n=16). The survey examined the reason(s) for restraint use, whether its use had been explained, consent obtained and documented, whether the restraint had been appropriately applied and patients monitored during the period when restraint was applied, and whether alternatives had been attempted. Interestingly, six patients were found to have had their restraints removed either before or after the survey. A slightly less restrictive form of restraint, boxing gloves, was used for seven patients instead of limbs holders. Three patients remained restrained. The results of this study revealed that there was room for improvement in practice of restraints, and that measures to reduce the use of restraints were not necessarily very costly. Applying physical restraints is counter-productive to rehabilitative care. Nurses and other health disciplines need to be better informed regarding restraint reduction programs.

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Prevalence and Variation of Physical Restraint Use in Acute Care Settings in the US

Cited by 132 publications

References 28 publications

Improving ICU Nurses’ Practices of Physical Restraints in Jordan: Effect of an Educational Program

Improving ICU Nurses’ Practices of Physical Restraints in Jordan: Effect of an Educational Program

Use of Physical Restraints in Dutch Intensive Care Units: A Prospective Multicenter Study

Use of Physical Restraints in a Rehabilitation Setting: Findings from a Point Prevalence Survey

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