The use of physical restraint in critical care

Hine, Karen

doi:10.1111/j.1478-5153.2006.00197.x

Cited by 61 publications

(70 citation statements)

References 28 publications

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“…In order to be used for multiple regression and correlation, categorical variables must be coded. For this study, the categorical variable of the Benner stage was coded as novice (1), advanced beginner (2), competent (3), proficient (4), and expert (5).…”

Section: Resultsmentioning

confidence: 99%

“…Novice nurses were less likely than expert nurses to have been taught any content about use of physical restraints in their basic nursing education. Use of physical restraints is still common, particularly in the critical care environment, [2][3][4][5][6][7] and novice nurses may be working there; thus, education about use of physical restraints strongly needs to continue to be included in nursing curricula.…”

Section: Discussionmentioning

confidence: 99%

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Nurses’ Attitudes, Clinical Experience, and Practice Issues With Use of Physical Restraints in Critical Care Units

Stinson

2016

American Journal of Critical Care

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Background Physical restraints are more likely to be used in critical care units than in other hospital units because use of invasive procedures and mechanical ventilation is more common in critical care units. Initiation and maintenance of physical restraint devices is largely a nursing responsibility. Previous clinical experience is a variable often suggested to be related to intensive care nurses’ use of physical restraints. Objective To examine the relationships between registered nurses’ clinical experience, their practice issues (nurses’ actions while caring for patients who are physically restrained), and their attitudes toward the use of physical restraints (feelings about use of restraints and about caring for patients who are restrained) in critical care units. Methods In a descriptive correlational study, data were collected online via the Physical Restraint Questionnaire. Participants’ (n = 413) clinical experience was classified by using Patricia Benner’s novice to expert framework. Results No strong correlation was found to explain any variance between attitudes toward use of physical restraints in critical care and clinical experience in nursing in general, clinical experience in critical care, and nursing practice issues with use of physical restraints. However, nurses with more clinical experience were more likely to have learned about use of physical restraints in their basic nursing curriculum. Conclusions The reported lack of content addressing use of physical restraints in today’s nursing curricula is a concern, as physical restraints are commonly used in critical care units.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nurses’ Attitudes, Clinical Experience, and Practice Issues With Use of Physical Restraints in Critical Care Units

Stinson

2016

American Journal of Critical Care

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“…In contrast, various articles were located that discussed the use of restraints in the clinical care of adult patients in the psychiatric setting, in the intensive care unit, and care of the elderly (Benbenbishty, Adams, & Endacott, 2010;Brenner, 2007b;Hine, 2007;Kontio et al, 2010; Lewis, Taylor control the movement of the patient during procedures (Bland et al, 2002;Collins, 1999;Demir, 2007b;Jeffery, 2002;Selekman & Snyder, 1996). The use of restraint has been an accepted practice during common procedures such as immunization, intramuscular injection, venipuncture, intravenous line placement, and lumbar puncture (Bland et al, 2002;Collins, 1999;Robinson & Collier, 1997).…”

Section: Use Of Experts and Physical Restraintmentioning

confidence: 99%

An Ethnography of the Culture of Pain in a Non-Pediatric Emergency Department

Cummings¹

2013

Journal of Pediatric Health Care

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Rationale for the Study: Despite the exponential growth in pharmacological and nonpharmacological methods for the treatment of pediatric procedural pain there remains a gap between available interventions and actual practice in the emergency department clinical setting. Researchers have recommended the examination of unit culture since culture is proposed to be a major factor that affects the implementation of pain management practices. Method:Ethnography was employed to gain access to the beliefs and practices of healthcare participants in a Northeastern non-pediatric emergency department. Data were collected for 5 months with over 100 hours of observation. Six key informants were interviewed and 44 pediatric procedural interactions with 27 healthcare providers during the treatment of children two to eight years of age undergoing procedures were observed.Other information gathered included documents from the institution, and pain related information from the patient's medical record. All interviews were recorded and transcribed verbatim. Data were managed using the Ethnograph 6.0 and analyzed using the procedure developed by Leininger and McFarland (2006). Results:Seven major themes with categories were discovered that included assessment, ii procedural pain, treatment of pain, communication related to comfort, fragmentation of care in the emergency department, healthcare provider attitudes, and environmental issues and policies. Conclusion:The results of this study suggest that practice environment of the emergency department and organizational culture exerted a significant degree of influence over healthcare providers' pediatric pain management practices. Nurses' did not use pain measurement tools as they were intended to be used and instead improvised measurement by observing the child's behavior. The management of children during painful procedures consisted of an array of behaviors and practices. The use of physical restraint during painful procedures was a common practice. Participants continue to hold many assumptions and misconceptions about pediatric pain assessment and management. The findings of this study provide insight to the everyday practice of emergency department healthcare providers for pediatric pain in a non-pediatric setting.iii Acknowledgments and Dedication

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“…This issue can be a challenge for the nurses of intensive care units (ICUs) who should create an immune environment for patients with agitation and delirium (4). More than 80% of the patients in ICUs may experience some degrees of agitation and delirium during the term of hospitalization (5,6) which is due to pain, systemic diseases, sleep deprivation, hypoxia, mechanical ventilation, myocardial ischemia, alcohol and drug deprivation and change in cellular metabolism (7).…”

Section: Introductionmentioning

confidence: 99%