Use of Physical Restraint in Intensive Care Units (ICUs) at Ain Shams University Hospitals, Cairo

Abstract

Abstract: There is still great controversy about the potential benefits, side effects and ethical issues associated with physical restraint (PR) use in critical care settings. Nurses’ views and attitudes toward the use of PR in controlling patients’ behavior and ensuring patient safety may create conflicts with patients’ rights, including their autonomy in making decisions for their own care. This study aimed to assess ICU nurses' knowledge, attitude and practice regarding use of PR in the ICU settings at Ain Shams University Hospitals and factors influencing it. Method: A convenience sample of 131 nurses working in ICU settings in Ain Shams University Hospitals was selected for this study. A self administered structured questionnaire was used to determine ICU nurses' knowledge, attitude and practice regarding use of PR and factors influencing it. Results: The respondents in this study were 110 nurses. Their total scores ranged from 6 to 14 (median: 10) for knowledge, 17 to 30 (median: 23) for attitude and 18 to 39 (median: 28) for practice regarding use of PR. There was significant positive correlation between respondent nurses' practice score and both of knowledge and attitude scores. Frequency of use of PR by the respondent nurses showed positive correlation with both of patient/nurse ratio and period of experience in ICU while there was negative correlation between it and educational background of the participant nurses. Conclusions: Practice of the participant nurses regarding use of physical restraint is related to their knowledge and attitude towards it. Also, use of PR was found to be affected by patient/nurse ratio as well as nurses' qualifications and duration of clinical experience. Recommendations: Development of local policies for PR use and periodic in service – training of ICU nurses on best practice guidelines are essential to improve nurses' practice regarding use of PR.