Nursing Personnel's Perceptions of Physical Restraint Use in Long-Term Care

Abstract

The use of physical restraints as an accepted clinical intervention was dramatically changed by enactment of legislation in the United States. As a result, nursing personnel's notions of restraints as a therapeutic intervention were challenged. This study was initiated to obtain a better understanding of the underlying motivations for restraint use as a clinical intervention and to provide data helpful to nursing staff as they make the transition to restraint-free care. In the study, 124 long-term-care nursing personnel were surveyed regarding their perceptions of restraint use, and were asked whether or not they would recommend using restraints in selected clinical situations. Results of stepwise regression showed that 40% of the variation in the recommendation to use restraints can be explained by the type of nursing personnel (licensed nurse vs. nursing assistant), liability and treatment concerns related to restraint use, age of the nursing staff, and a belief that reducing restraints increases the need for psychoactive medications.

The factors that influence nurses' use of physical restraint: A thematic literature review

“…Sampling procedures and study design were provided, with all 18 researchers' citing sampling method, strategy and analysis of the data. Varone et al ., 8 Schirm et al ., 25 Myers et al 3 . and Janelli et al ., 19 however, reported limited information about the methodology, strategy and design of the study.…”

“…The larger the sample, the greater the probability of it representing the population 27 . Apart from three pilot studies, 3,10,25 power analysis (determining if sample size is sufficient) was absent from all quantitative studies, making it difficult to distinguish if an effect was there or not 28…”

Knowledge, Attitudes, and Practices of Turkish Intern Nurses Regarding Physical Restraints

“…Schirm et al 40 found that 40% of the nurses considered the use of physical restraints as a natural part of care and treatment responsibilities and that they were not aware of the negative aspects of the use of physical restraints. Thomas et al 41 found that nurses widely applied physical restraints for practical reasons, even though they were aware of alternative interventions and the adverse effects of physical restraint use.…”

Nursing staff perceptions of the behaviour of older nursing home residents and decision making on restraint use: a qualitative and interpretative study

“…Decision making on the use or avoidance of restraints is complicated on the one hand by various external factors, such as institutional policy, legal and ethical issues, family and other societal pressures, and nurses’ professional values; and on the other hand by a number of internal factors, such as nurses’ personal values, attitudes and personal dilemmas (Kikuta, 1991; Morse & McHutchion, 1991; Scherer et al ., 1991; Werner et al ., 1994; Janelli et al ., 1995; Mahoney, 1995; Molassiotis & Newell, 1996; Sullivan‐Marx, 1996). It has been argued that the elimination of restraint use will require changes in nurses’ actions as well as in environmental conditions (Blakeslee et al ., 1991; Morse & McHutchion, 1991; Rader, 1991; Kayser‐Jones, 1992; Schirm et al ., 1993; Kolanowski et al ., 1994; Mahoney, 1995; Nelson, 1995; Phillips et al ., 1996).…”