Nurses’ Knowledge, Attitude, and Influencing Factors regarding Physical Restraint Use in the Intensive Care Unit: A Multicenter Cross-Sectional Study

Background. Physical restraint is a common practice in the intensive care units which often result in frequent skin laceration at restraint site, limb edema, restricted circulation, and worsening of agitation that may even end in death. Despite the sensitivity of the problem, however, it is felt that there are nurses’ evidence-based practice gaps in Ethiopia. To emphasize the importance of this subject, relevant evidence is required to develop protocols and to raise evidence-based practices of health professionals. So, this study aimed to assess the knowledge, attitude, and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia. Methods. An institution-based cross-sectional study was maintained from March to September 2019 at Amhara regional state referral hospitals, northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff regarding Physical Restraints Questionnaire was used to assess the nurses’ knowledge and attitude. Linear regression analysis was employed to examine the influencing factors of knowledge and attitude. Adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used to report the result of association with a p value < 0.05 statistical significance level. Result. The mean scores of nurses’ knowledge and attitude regarding physical restraint use among critically ill patients were 7.81 ± 1.89 and 33.75 ± 6.50, respectively. These mean scores are above the scale midpoint nearer to the higher ranges which imply a moderate level of knowledge and a good attitude regarding physical restraint. Lower academic qualification and short (<2 years) work experience were associated with lower-level of knowledge, and reading about restraint from any source and taken training regarding restraints were factors associated with a higher knowledge. Diploma and bachelor’s in academic qualification were significantly associated with a negative attitude regarding restraint. Besides, there was a more positive attitude among nurses with a higher level of knowledge and who received training regarding physical restraint use. Conclusion. The nurses working in the intensive care unit had a moderate level of knowledge and a good attitude regarding physical restraint use. So, developing and providing educational and in-service training to the nurses regarding physical restraint are necessary to strengthen the quality of care for critically ill patients.

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Nurses Practice and Influencing Factors regarding Physical Restraint use in the Intensive Care Units in Northwest Ethiopia

10.21203/rs.3.rs-16391/v2 ◽

2020 ◽

Author(s):

Tilahun Kassew ◽

Ambaye Dejen Tilahun ◽

Bikis Liyew

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Critically Ill ◽

Influencing Factors ◽

Critically Ill Patients ◽

Physical Restraint ◽

Northwest Ethiopia ◽

Evidence Based ◽

Restraint Use ◽

Level Of Knowledge

Abstract Background: Physical restraint is a common clinical practice in intensive care units. Even though physical restraint is used to prevent the removal of life support tubes and risk of a patient’s falling injure; complications such as edema, laceration, and pain at the restrained site, restricted circulation, worsening of agitation or delirium that may end with death are frequently encountered. Despite the sensitivity of the problem, there are gaps in nurses’ evidence-based practice in Ethiopia. Before developing protocols and guidelines relevant evidence-based practices of nurses are required. So, this study aimed to assess the practice and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff Regarding Physical Restraints Questionnaire was used to assess the nurses’ knowledge, attitude, and practice. Linear regression analysis was computed to examine the influencing factors of nurses' practice. An adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used to report the result of association. Statistical significance was declared at p-value<0.05. Result: The mean score of the nurses’ practice regarding physical restraint use among critically ill patients was 30.94±5.44. This mean score is above the scale midpoint nearer to the higher range that implies the majority of nurses have a satisfactory practice regarding physical restraint. Less than or equal to 2 years of work experience [β= -1.34, 95% CI (-2.47, -0.21)] was significantly associated with poor nurses practice; received training regarding restraints [β= 1.49, 95% CI (0.16, 2.82)], higher level of knowledge [β=0.40, 95% CI (0.03, 0.78)] and better attitude scores [β=0.37, 95% CI (0.27, 0.47)] were associated with good nurses practice regarding physical restraint use.Conclusion: Nurses working in the intensive care units had a satisfactory practice regarding physical restraint use on critically ill patients. So developing and providing educational and in-service training to the nurses on the alternative strategies, complications, and risks of physical restraint are important to strengthening the quality of nursing care for critically ill patients.

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Investigating influencing factors of physical restraint use in China intensive care units: A prospective, cross-sectional, observational study

Australian Critical Care ◽

10.1016/j.aucc.2018.05.002 ◽

2019 ◽

Vol 32 (3) ◽

pp. 193-198 ◽

Cited By ~ 12

Author(s):

Ting Gu ◽

Xu Wang ◽

Nan Deng ◽

Weiqun Weng

Keyword(s):

Intensive Care ◽

Observational Study ◽

Intensive Care Units ◽

Influencing Factors ◽

Physical Restraint ◽

Cross Sectional ◽

Restraint Use

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Practice and the Influencing Factors of Nurses Working in the Intensive Care Unit regarding Physical Restraint use: Multi-centered cross-sectional study

10.21203/rs.3.rs-16391/v1 ◽

2020 ◽

Author(s):

Tilahun Kassew Gebeyehu ◽

Ambaye Dejen Tilahun ◽

Bikis Liyew Wudu

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill ◽

Influencing Factors ◽

Critically Ill Patients ◽

Physical Restraint ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Restraint Use

Abstract Background: Nurses working in the intensive care unit commonly use physical restraint on critically ill patients. The main reason for the restraining of patients is to prevent the dislodgement of invasive procedures/ medical equipment, reduce agitation. Patients are exposed to different complications from physical restraint like worsening of agitation and delirium, fall injury, limb edema, restricted circulation, and skin laceration at restraint site, and death as a result of nurses’ improper practice regarding restraining. Despite this impact, there was no documented study in Ethiopia in this regard. Objective: To assess practice and its influencing factors of nurses working in the Intensive Care Unit regarding physical restraint Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. All (260) nurses working in the intensive care unit were invited to participate through a convenience sampling technique. Structured questionnaires which consist of socio-demographic, professional characteristics and Level of Knowledge, Attitudes and Practices of Staff Regarding Physical Restraints Questionnaire were used. Simple and multiple linear regression and beta (β) coefficient at 95% confidence interval was employed with p-value<0.05 as statistical significance. Result: The mean score of nurses’ practice regarding physical restraint use among critically ill patients was 30.94±5.44. Nurses with short (≤2 years) experience of the intensive care unit, received educational training during graduate class regarding restraining, knowledge and attitude scores were the factors significantly associated with nurses’ practice score regarding physical restraining use. Conclusion: The practice regarding physical restraint use among critically ill patients among participant nurses’ was a satisfactory. The administrators’ should develop and provide educational and in-service training programs for nurses working in intensive care unit settings regarding physical restraint use and its alternatives, which is crucial for the nurses’ to improve their behavior of restraining. Keywords: Intensive care unit, Nurses’, Practice, Physical restraint

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The challenges of using physical restraint in intensive care units in Iran: A qualitative study

Journal of the Intensive Care Society ◽

10.1177/1751143719892785 ◽

2020 ◽

pp. 175114371989278

Author(s):

Zahra Salehi ◽

Soodabeh Joolaee ◽

Fatemeh Hajibabaee ◽

Tahereh Najafi Ghezeljeh

Keyword(s):

Critical Care ◽

Intensive Care ◽

Qualitative Study ◽

Intensive Care Units ◽

Physical Restraint ◽

Critical Care Nurses ◽

Structured Interviews ◽

Standard Equipment ◽

Restraint Use ◽

Ensure Patient Safety

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

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Analysis of a nurses’ knowledge survey on the use of physical restraint in intensive care units

Enfermería Intensiva (English ed ) ◽

10.1016/j.enfie.2019.04.001 ◽

2019 ◽

Vol 30 (2) ◽

pp. 47-58

Author(s):

G. Via-Clavero ◽

L. Claramunt-Domènech ◽

A. García-Lamigueiro ◽

M.M. Sánchez-Sánchez ◽

M. Secanella-Martínez ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Physical Restraint ◽

Knowledge Survey ◽

Nurses Knowledge

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Nurses knowledge and attitudes regarding physical restraint in Turkish intensive care units

Nursing in Critical Care ◽

10.1111/nicc.12541 ◽

2020 ◽

Cited By ~ 1

Author(s):

Büşra Ertuğrul ◽

Dilek Özden

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Physical Restraint ◽

Knowledge And Attitudes ◽

Nurses Knowledge

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Predictors of physical restraint use in Canadian intensive care units

Critical Care ◽

10.1186/cc13789 ◽

2014 ◽

Vol 18 (2) ◽

pp. R46 ◽

Cited By ~ 27

Author(s):

Elena Luk ◽

Barbara Sneyers ◽

Louise Rose ◽

Marc M Perreault ◽

David R Williamson ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Physical Restraint ◽

Restraint Use

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Jordanian Intensive Care Unit Nurses’ Knowledge of Delirium Recognition

Global Journal of Health Science ◽

10.5539/gjhs.v9n4p182 ◽

2016 ◽

Vol 9 (4) ◽

pp. 182 ◽

Cited By ~ 1

Author(s):

Mohannad Eid AbuRuz

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Health Care Providers ◽

Clinical Syndrome ◽

Basic Knowledge ◽

Knowledge Level ◽

Care Providers ◽

Graduate Studies ◽

Cross Sectional ◽

Nurses Knowledge

INTRODUCTION: Delirium is a clinical syndrome that negatively affects the outcomes of the intensive care units patients if undetected early and treated well. However, this condition remains under recognized and poorly managed by health care providers including nurses. The objective of this study was to check nurses' knowledge level about delirium recognition.MATERIALS & METHODS: This was a cross-sectional study on 176 intensive care units nurses working in four major hospitals in Amman, Jordan. Data were collected using a self-reported likert scale questionnaire.RESULTS: Nurses lack the basic knowledge about delirium recognition; the mean was (52.65 ± 4.99). Older nurses (aged 31 years and above) have significantly higher levels of knowledge regarding delirium recognition compared to younger nurses (mean ± SD, 56.02 ± 18.1 vs. 49.28 ± 12.65, P < .005). Moreover, nurses with longer experience in intensive care units were more knowledgeable about delirium recognition (r=0.73, p <.001).Graduate studies have a positive effect on the knowledge level. Nurses holding master degree have significantly higher levels of knowledge regarding delirium recognition compared to those with Baccalaureate degree; (mean ± SD, 60.28 ± 16.86 vs. 53.0 ± 12.18, P < .005).CONCLUSION: Delirium is a widespread disorder in the intensive care units. Jordanian nurses lack the basic knowledge regarding essential characteristics of delirium and its recognition. Education of nurses in all care settings is vital and necessary.

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