Nurses using physical restraints: Are the accused also the victims? – A study using focus group interviews
Open Access
- 17 July 2007
- journal article
- Published by Springer Science and Business Media LLC in BMC Nursing
- Vol. 6 (1), 5
- https://doi.org/10.1186/1472-6955-6-5
Abstract
To date, the literature has provided an abundance of evidence on the adverse outcomes of restraint use on patients. Reportedly, nurses are often the personnel who initiate restraint use and attribute its use to ensuring the safety of the restrained and the others. A clinical trial using staff education and administrative input as the key components of a restraint reduction program was conducted in a rehabilitation setting to examine whether there were any significant differences in the prevalence of restraint use pre- and post-intervention. Subsequent to the implementation of the intervention program, focus group interviews were conducted to determine the perspective of the nursing staff on the use of restraints and their opinions of appropriate means to reduce their use. Registered nurses working in units involved in the study were invited to participate in focus group interviews on a voluntary basis. Twenty-two registered nurses (three males [13.6%] and nineteen females [86.4%]) attended the four sessions. All interviews were audio taped and transcribed verbatim. Other than the author, another member of the project team validated the findings from the data analysis. Four themes were identified. Participants experienced internal conflicts when applying physical restraints and were ambivalent about their use, but they would use restraints nonetheless, mainly to prevent falls and injuries to patients. They felt that nurse staffing was inadequate and that they were doing the best they could. They experienced pressure from the management level and would have liked better support. Communication among the various stakeholders was a problem. Each party may have a different notion about what constitutes a restraint and how it can be safely used, adding further weight to the burden shouldered by staff. Studies about restraints and restraint use have mostly focused on nurses' inadequate and often inaccurate knowledge about the use of restraints and its associated adverse effects. These studies, however, fail to note that nurses can also be victims of the system. Restraint use is a complex issue that needs to be understood in relation to the dynamics within an environment.Keywords
This publication has 32 references indexed in Scilit:
- Staff's attitudes to the use of restraint and seclusion in a Norwegian university psychiatric hospitalNordic Journal of Psychiatry, 2003
- Avoiding Physical Restraints in Long-Term Care FacilitiesJournal of the American Medical Directors Association, 2003
- The use of physical restraints as a safety measure in the care of older people in four rehabilitation wards: findings from an exploratory studyInternational Journal of Nursing Studies, 2002
- The use of physical restraint of hospitalized elderly patients*Journal of Psychiatric and Mental Health Nursing, 1999
- Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong KongJournal of Advanced Nursing, 1999
- Physical Restraint: a descriptive study in swiss nursing homesNursing Ethics, 1998
- Physical Restraint: a descriptive study in Swiss nursing homesNursing Ethics, 1998
- Nurses' awareness of restraint use with elderly people in Greece and the U.K.: a cross-cultural pilot studyInternational Journal of Nursing Studies, 1996
- Myths about Elder RestraintImage: the Journal of Nursing Scholarship, 1990
- Physical Restraint of the Hospitalized ElderlyNursing Research, 1988