The Physical Restraint Application and its Effect in Acute Care Settings
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Introduction
Physical restraint (attaching physical or mechanical devices to the body) of a patient and preventing them from moving easily is one of the common methods used for patient agitation management, fall prevention, and medical device removal. Therefore, it is only allowed to be used for the short-term care needs of the patient. Given the older adults' vulnerability and advocacy needs, physical restraint should be managed in an ethical and person-centred care framework.
Project Outline
Aim
My research aims to determine the rate, practice, and complications of physical restraint in acute health settings in older adults and develop feasible guidelines in line with these needs.
Methods
The mixed method, cohort observation, qualitative analysis, systematic review, Delphi, and quasi-experimental pre-post cohort study designs were used.
Co-produced clinical guidelines on physical restraint, staff education and monitoring adherence to guidelines
Results
In qualitative interviews, patients and families described the ‘emotional effect of physical restraint’ while staff spoke of ‘inevitability’ of restraint use in managing disruptive behaviour and due to staff shortages. The co-development of clinical guidelines with staff resulted in a reduction in use of restraints and improved patients outcomes.
Conclusion
Physical restraint use in acute care can be reduced through appropriate staff training, monitoring and implementation of clinical guidelines. The voice of patients and families needs to be central in developing person-centred care and reducing unintended consequences of physical restraint use.
Project Outputs
Physical Restraint Experiences of Family Caregivers of Patients With Stroke in Turkey: A Qualitative Study: (opens in a new window)Full Report
Nurses' knowledge and attitudes regarding physical restraint in Turkish intensive care units: (opens in a new window)Full Report
The effect of physical restraint on neurovascular complications in intensive care units: (opens in a new window)Full Report
A Summary of Available Evidence-Based Guidelines about Physical Restraint Used in ICU: A Systematic Review [CRD42020161017]
Next Steps...
Future work aims to replicate the study in Irish acute care settings