Changing the Practice of Physical Restraint Use in Acute Care
The use of physical restraint in health care institutions has been challenged for over two decades by nurses and health professionals who considered the practice overused, unethical and inappropriate in many cases. Physical restraints have not been shown to prevent the key problems for which they are used most often (falls or pulling out devices), and in fact, continue to be associated with negative outcomes for patients, including death. Despite the continued evidence of restraint problems and lack of efficacy, restraint use continues to be common and misunderstood.
The purpose of this evidence-based practice guideline is to assist nurses and other health care professionals in reducing the use of physical restraints for patients in acute care settings. This guideline identifies individual patient characteristics as well as characteristics of staff and facilities associated with restraint use. Additionally, it provides alternative strategies and approaches to restraint-free care. The recommendations found in this guideline are designed to assist healthcare professionals to: 1) facilitate the recognition of older adults at risk for restraints to aid in prevention; 2) provide assessment criteria to identify underlying causes of unsafe behavior that will lead to alternative individualized interventions; and 3) assist those in settings that still employ restraints to move toward restraint-free care. Written 1996 (originally titled Restraints); Revised 2005; 2014.
Toolkit Included in Guideline:
- Decision Algorithm for Restraint Free Care
- Behavior Log
- Nursing Interventions Classifications (NIC): Physical Restraint – 6580
- Nursing Outcomes Classifications (NOC): Agitation Level - 1214
- Restraint Knowledge Assessment Test
- Staff Perceptions Questionnaire
- Unit & Facility Monitor
Permission to Copy & Copyright Notice:
To obtain permission to copy a guideline toolkit click HERE and fill out the form presented to you. Once you've submitted this form, please allow up to 6 to 10 business for your request to be reviewed. At that time, we will contact you by email to inform you of our decision.
Before you proceed, please note we do not grant permission to use and/or copy any one individual tool not developed under the Barbara and Richard Csomay Center for Gerontological Excellence. For individual tool use, please contact the author/publisher of that tool.
By purchasing and downloading permissions for the Guideline and Toolkit you agree to the following terms:
- Guideline and Toolkit are for private, internal, non-commercial use only (unless special permissions are obtained).
- If the Guideline and Toolkit will be distributed online, it must be password protected and unavailable to the general public.
- Guideline and Toolkit cannot be modified without expressed consent from author(s) and/or publisher.
- You must give appropriate credit when using materials from the Guideline and Toolkit by using the citation on the Contact Information (or Contact Resource) page of the Guideline and place the following copyright notice at the bottom of the page, " ©2018 the University of Iowa, College of Nursing, Barbara and Richard Csomay Center for Gerontological Excellence. All rights reserved. Do not copy or reproduce without permission."
- You may not reprint and/or redistribute materials from the Guideline or Toolkit for any of your own publications. Please email Csomay-Center@uiowa.edu if you wish to obtain permission to use material from the Guideline or Toolkit in a publication.