Knowledge, Attitude, and Practice of Nurses Working in the Adult Intensive-Care Unit and Associated Factors towards the Use of Physical Restraint in Federally Administered Hospitals in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

Abstract

Background. Physical restraint is any chemical or physical involuntary method restricting an individual’s movement, physical activity, or normal access to the body. Physical restraints are prescribed by the physician, but the ICU nurse remains the decision maker responsible in assessing the need, application, and removal of PR on patients in the ICU setting. Objectives. This cross-sectional descriptive study was carried out to determine the knowledge, attitudes, and practices of nurses working in adult ICU and associated factors towards the use of physical restraints in federally administered hospitals in Addis Ababa, Ethiopia, 2019. Methods. The study was conducted in ICUs of Federal Hospitals in Addis Ababa, Ethiopia, 2019. A hospital-based descriptive cross-sectional study design was carried out. By census, a total of 126 nurses were included. The data were checked for their completeness and were entered to EpiData version 4.2 and analyzed using SPSS version 25 software with 95% CI. Also, the Pearson correlation coefficient and binary logistic regression analysis were used to find an association. Result. Majority of nurses was found to be aged between 21 and 30 years, (62.5%) have worked 2–5 years, and (83%) were degree graduates. The nurses’ knowledge score was 6.1 ± 2.6 (50.8%) with possible range 0–11, the attitude score was 14.1 ± 3.1 (64%) with possible range 0–22, and the practice score was 13.9 ± 3.8 (63.18%) with possible range 0–22. Their demographical characteristics such as gender, working year, and education levels were not significantly associated with knowledge, attitudes, and practices ( P > 0.05). Only age significantly associated with practice. Lack of a written policy or guideline and not being trained on application of physical restraint were significantly associated with knowledge. Also, practice was associated with knowledge and attitude. Conclusion. According to the study, there was a poor level of nurses’ knowledge, proper attitude, and satisfactory practice toward the use of physical restraints.

Pressure ulcer prevention knowledge, practices, and their associated factors among nurses in Gurage Zone Hospitals, South Ethiopia, 2021

“…This result was similar to the studies reported from Australia, 22 German, 32 South Africa, 15 Embu in Kenya, 25 and Addis Ababa. 16 The result is also similar to reports in Federal Hospitals in Addis Ababa 30 and Wollega, Ethiopia. 21 The reason might be due to the use of guidelines used as a direct source of information and hold sets of systematic procedures that were expected from nurses for pressure ulcer prevention and having good knowledge.…”

“…27 South Africa, 15 Uganda, 14 Umgungundlovu District in South Africa, 28 and National Orthopedic Hospital of Enugu in Nigeria 29 show that nurses have poor knowledge of pressure ulcer prevention. Similarly, the levels of knowledge were poor in the studies conducted in Federally Administered Hospitals in Addis Ababa, 30 Gondar University Hospital, 20 Hawassa University comprehensive specialized hospital, 31 and public hospitals in Wollega 21 relative to this study finding (Figure 1). The difference might be due to a change of methodology and also might be due to increased knowledge source of information, scientific evidence, and research results, along with increased educational level of health care workers (qualification) that might also be the cause of the difference.…”

“…33 Also, the study finding was similar to studies in South Africa, 15 Gondar University, 20 Harari regional state and Dire Dawa, 33 and Public hospitals in Addis Ababa, 16 Federally Administered Hospitals in Addis Ababa. 30 While studies conducted in Sweden, 10 Japan, 23 Lohar university hospital, 27 University of Maiduguri Teaching Hospital in Nigeria, 34 Uganda, 14 Umgungundlovu District in South Africa, 28 Enugu in Nigeria, 29 and Gondar University Hospital 20 had poor pressure ulcer prevention practices relative to this study finding (Figure 2), which was good pressure ulcer prevention practices. The reason might be due to nurses having a good level of knowledge and increasing scientific evidence, using guidelines on pressure ulcer prevention source of knowledge, and increasing the overall health care delivery system for hospitalized patients which might be the difference.…”

“…33 Also, the study finding was similar to studies in South Africa, 15 Gondar University, 20 Harari regional state and Dire Dawa, 33 and Public hospitals in Addis Ababa, 16 Federally Administered Hospitals in Addis Ababa. 30…”

Critical care nurses' experiences of physical restraint in intensive care units: A qualitative systematic review and meta‐synthesis

“…As the main decision makers and practitioners, critical care nurses play a vital role in using physical restraint. Several quantitative studies explored critical care nurses' knowledge, attitudes, and behaviours towards physical restraint (Almomani et al, 2021; Ertuğrul & Özden, 2021; Woldekirkos et al, 2021). The findings showed that critical care nurses lacked knowledge about physical restraint and were unsure about using alternatives.…”