Effects of a Web-Based Educational Program Regarding Physical Restraint Reduction in Long-Term Care Settings on Nursing Students: A Cluster Randomized Controlled Trial

Physical restraint is still frequently used in many countries. However, a lack of education hinders physical restraint reduction in long-term care facilities. No study has yet to examine the effects of physical restraint reduction education on nursing students. This study aimed to evaluate the effects of a web-based educational program of physical restraint reduction on nursing students’ knowledge and perceptions. A cluster randomized controlled and single-blind design was used. This study was conducted at four nursing schools in South Korea. A total of 169 undergraduate nursing students completed this study. Using random allocation, two nursing schools (85 students) were allocated as the experimental group and the other two schools (84 students) as the control group. The experimental group received the web-based educational program, and the control group did not receive the educational program. Data were collected immediately before and after the web-based educational program. The experimental group’s knowledge and perceptions significantly improved between pre-test and post-test. The analysis of covariance showed statistically significant differences between groups in knowledge (p < 0.001) and perceptions (p < 0.001) over time, revealing positive effects of the web-based educational program. The web-based educational program regarding physical restraint reduction positively affected nursing students’ knowledge and perceptions. Future studies are required to examine the educational program’s longitudinal effects with more rigorous measurements and research methods.

Minimizing the Use of Restraint in Patients with Mental Disorders at a Mental Hospital: A Systematic Review

Background: Restraint in the psychiatric unit is a common practice but it is very controversial and it has undergone a poor evaluation according to methodological investigations. Using restraint is a common problem and has a significant impact on patients, families and health care staff. Therefore, this systematic review will discuss the important reasons as to why restraint should be reduced. It will also explain several alternative treatments for aggressive patients in mental hospitals.Method: The database searches were used to identify potential articles: Scopus and Proquest were the focus. The search was limited to those published in the range of the last 5 years from 2013 to 2018. The keywords that were used were ‘restraint in the hospital’, ‘restraint reduction’, ‘the elimination of restraint’ and ‘physical restraint’.Result: Only 15 articles met the inclusion criteria. The results suggest that restraint is considered to be a violation of human rights and that it traumatizes the patients. It is inhuman and degrading. Besides this, restraint can result in physical complications in the form of lacerations, asphyxia, thrombosis and death. Restraint is permitted when other methods fail and in emergency conditions.Conclusion: Some of the ways to reduce the use of restraint are by constant monitoring and through the control of individual behavior, including verbal management and attitudes, reducing the environmental risks, and administering drugs. Some of the efforts to avoid restraint are the "Positive and Safe in Calderstones" program, sensory modulation and peer advice and support.

Return of the asylum

SummaryRates of involuntary admission are increasing in England. Personality disorder should be excluded as a criterion for involuntary admission; stronger restraint reduction programmes should be instigated; and involuntary care should be based on treating illness (something we can do) and not on predicting violence (something we cannot).Declaration of interestNone.