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Changing the Practice of Physical Restraint Use in Acute Care
Changing the Practice of Physical Restraint use in Acute Care


 
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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


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