Restraining children for clinical procedures: a review of the issues

Abstract

The aim of this discussion is to explore the issue's procedural restraint of children raises for nursing staff caring for children, from both a policy and a research perspective. Specifically the discussion defines the various terms that describe the process of restraint and proceeds to examine the issues that continue to challenge nursing practice in this area: the professional and policy context; professional considerations; parental perceptions; and involvement. Whilst recognizing the difficulties faced by student nurses when involved in restraint. The pivotal role played by the child's nurse will determine the quality of the service experienced; whilst acting as the child's advocate they are the health professional most directly involved in care. The discussion closes by highlighting the main issues nurses face when deciding to restrain and child and thoughts for future practice.

A private affair: children's experiences prior to colonoscopy

“…This is something to bear in mind when preparing children for a procedure in a healthcare setting (Hull & Clark ). Furthermore, children who are satisfied with the amount of information they have received rate themselves as less frightened to return to the hospital (Gordon et al .…”

“…Children want to actively participate in decisions made about their care, and age-appropriate information can reduce stress as well as anxiety (Jaaniste et al 2007, Hull & Clark 2010. Children aged 7-11 years think logically, and over the age of 11, children develop abstract thinking (Piaget & Inhelder 1969).…”

“…However, another factor to be taken into account, besides chronological age, is a child's wish to agree with a given decision depending upon their own related experience, the type of decision, information and support given by adults (Alderson et al 2006). This is something to bear in mind when preparing children for a procedure in a healthcare setting (Hull & Clark 2010). Furthermore, children who are satisfied with the amount of information they have received rate themselves as less frightened to return to the hospital (Gordon et al 2010).…”

Experience and nursing needs of school‐age children undergoing lumbar puncture during the treatment of acute lymphoblastic leukaemia: a descriptive and qualitative study

“…They expected the nurses to hold their hands and listen to them carefully. Hull and Clark (Hull & Clarke ) described how important it is to focus on the manner in which communication is implemented, instead of merely focusing on what is being communicated. The healthcare staff could use body language to improve communication with children undergoing LP (Ji ) and distract their attention in a variety of ways, such as playing music and telling stories.…”

Perceptions of parents and paediatricians on pain induced by bone marrow aspiration and lumbar puncture among children with acute leukaemia: a qualitative study in China

“…In general, children's reactions were reported to be negative for physical restraint, including the following: anger, anxiety, abandonment, being punished in addition to fear, loss of control and vulnerability. 33 The use of restraint could be justified as acting in the child's best interest, 34 …”