Knowledge, Attitudes, and Practices of Nurses in Intensive Care Units on Physical Restraint Use and Factors Affecting Nurses’ Decisions to use them

Abstract

Objective: Physical restraints are used in intensive care units (ICUs) to prevent patients from harming themselves. In this study, we identified the physical restraint practices of nurses in ICUs and investigated their knowledge on this subject and factors affecting their decisions to use restraints. Material and Methods:This was a descriptive and cross-sectional study. The sample group consisted of nurses (n=101) who worked in the ICUs of a university hospital and a state hospital in Edirne. Data were collected using the "Questionnaire Form," which included working life and demographic characteristics of the nurses, and "Attitudes, Levels of Knowledge, and Practices of Staff Regarding the Physical Restraint Questionnaire." Data were evaluated using percentages, arithmetic means, percentages, and Mann-Whitney U and Kruskal-Wallis tests using IBM SPSS Statistics 21.0.Results: It was found that 62.4% of the nurses did not receive training on the use of physical restraints and that 81.2% of them practiced using physical restraints if required. The mean score of knowledge, attitude, and practice of the nurses on physical restraint use were 7.6±1.6, 30.4±4.2, and 36.8±3.7, respectively. A relationship was found between the knowledge score on physical restraint use and education on physical restraints (p=0.02) and between the attitude score on physical restraint use and the nurses' education degree (p=0.03). A statistical difference was found between the working units (p=0.002) and education on the use of physical restraints (p=0.000). This study found that only 38.6% of the nurses always used physical restraints on a physician's order. Conclusion:We found that although a majority of nurses working in ICUs did not receive training on the use of physical restraints, the level of knowledge on nurses' use of physical restraints and their attitudes to practice restraint use was positive. However, nurses' practice on the use of physical restraints on the order of the physician and the approval of enlightenment were not to the desired level during the practice of physical restraint use. It would be useful to focus on the responsibilities of nurses in relation to the topic of in-service training to be organized on the use of physical restraints. Bulgular: Bu çalışmada, hemşirelerin %62,4'ünün fiziksel kısıtlama uygulaması ile ilgili eğitim almadıkları, %81,2'sinin gerektiğinde hastalarına fiziksel kısıtlama uyguladıkları belirlendi. Hemşirelerin fiziksel kısıtlama kullanımına ilişkin bilgi puanı ortalaması 7,6±1,6, tutum puanı ortalaması 30,4±4,2 ve uygulama puanı ortalaması 36,8±3,7 olarak bulundu. Katılımcıların fiziksel tespit edici kullanımına ilişkin bilgi puanlarının fiziksel tespit uygulaması ile ilgili eğitim alma durumuna göre (p=0,02), tutum puanlarının eğitim durumlarına göre (p=0,03), uygulama puanlarının ise çalışı-lan birim (p=0,002) ve fiziksel tespit uygulaması ile ilgili eğitim alma durumuna göre (p=0,000) farklılık gösterdiği bulundu. Çalışmada, hemşirelerin sadece %38,6'sının fiziksel kısıtlamayı her zaman...

Nurses' knowledge, attitudes and practices related to physical restraint: a cross‐sectional study

“…), intensive care units (Azab & Negm ; Gurdogan et al. ) and psychiatric settings (Gelkopf et al. ) by many studies with different questionnaires.…”

“…However, Gurdogan et al. () state that nurses in intensive care settings show positive attitudes towards physical restraint use. The findings reported by Azab & Negm () differ from those of above studies, they claim that the participating nurses' practices regarding physical restraint use are related to their knowledge and attitudes and are affected by their qualifications and duration of clinical experience.…”

“…Suen et al (2006, p. 21) address that 'nurses' knowledge about restraint and their underlying attitudes toward physical restraint use should be identified because knowledge and attitudes can directly or indirectly affect practices'. Nursing staffs' knowledge, attitudes or practices about physical restraint use has been surveyed in nursing homes (Hamersv et al 2009), intensive care units (Azab & Negm 2013;Gurdogan et al 2016) and psychiatric settings (Gelkopf et al 2009) by many studies with different questionnaires. Hamers (2005) claim that nurses hold rather neutral opinions regarding physical restraint use and that nurses with more clinical experience show more negative attitudes.…”

“…These findings are consistent with those of Gelkopf et al' (2009) study, conducted in psychiatric settings, which states that nurses' emotional reactions towards restraining procedures are generally negative. However, Gurdogan et al (2016) state that nurses in intensive care settings show positive attitudes towards physical restraint use. The findings reported by Azab & Negm (2013) differ from those of above studies, they claim that the participating nurses' practices regarding physical restraint use are related to their knowledge and attitudes and are affected by their qualifications and duration of clinical experience.…”

Evaluation of patient relatives’ opinions on physical restraint

“…Both studies around the world and in Turkey suggest that physical restraint is used in order to reduce the risk of falling from the bed, to prevent the removal of medical device connections such as catheters, tubes, drains, etc., to facilitate the care and treatment given by healthcare personnel and to prevent agitated patients from harming themselves and their environment. 25,27,29,[31][32][33] As an interesting result obtained from the quantitative data in this study, physical restraint was used more frequently with the male patients. Similarly, according to studies conducted with respect to patients' gender, physical restraint is used more frequently with male patients.…”