Revista de Enfermagem e Cuidados com o Paciente

Registered Nurses’ Use of Physical Restraints on the Medical Floor in a Jamaican Hospital

Lawrence ES, Dawkins PE and Barton-Gooden A

Objectives: To explore registered nurses use of physical restraints on the medical floor of an acute care hospital in Kingston, Jamaica

Methods: This descriptive cross-sectional study included 90 registered nurses working on the medical floor. Data collection utilized a 17-item self – administered adapted version of the Perceptions of Restraint Use Questionnaire (PRUQ). Data were analyzed using the Statistical Package for Social Sciences SPSS® version 20 for Windows®.

Results: The response rate was 85.7% f (N=90). Participants were female (97%) and ages ranged between 20-29 years (60%). The majority (88%) had baccalaureate degree (88%) and 40% of this number had worked as a registered nurse for less than two years. Registered nurses reported using physical restraints to reduce the likelihood of patients either falling out of bed (4.41±0.95), breakage of sutures (4.26±0.88) or pulling out intravenous line (4.14±0.79) out of a maximum score of 5. Nurses indicated that the time of day influenced physical restraint usage with the night shift accounting for 71.1%. Confused patients were more likely to be restrained (78.9%). The majority (76.7%) of study participants were knowledgeable of the institution’s physical restraint policy but (83% reportedly received no training in its application.

Conclusion: Nurses on the medical wards utilized physical restraints to ensure patient safety and facilitate treatment continuation. Patient characteristics, lack of training and institutional support were contributing factors to physical restraint usage. When institutional support is inadequate, nurses’ intention to prevent patient harm and meet professional obligation might contribute to the reliance on the use of physical restraint.