The effects of nurse education on physical restraint use in the ICU

Kim, Yoon Hee; Jeong, Yu Soon; Park, Joo Hyun; Yoon, Seok Hwa

Abstract

BACKGROUND
Physical restraint is widely used to prevent self-harm and treatment interference in the intensive care unit (ICU)s, but it can cause adverse effects such as physical, psychological, and ethical problems. We examined the effect of nurse education on physical restraint use in the ICU.
METHODS
For 3 months before an ICU patient restraining program (IPRP), we investigated the application ratio of physical restraint, the incidence of complications and self-medical device breakage (self-extubation, self removal of intravenous line, etc.) Then we educated the 49 ICU nurses with an IPRP. The same data was collected again for 3 months after IPRP, and we also collected data from ICU nurses on their knowledge, attitude, and intention when applying physical restraint using questionnaires before and after IPRP education.
RESULTS
After IPRP education, the nurses' knowledge about physical restraint use improved significantly and their intension for restraint decreased. The physical restraint application ratio did not change significantly in the period before IPRP (146/475, 30.7%) compared to the period after IPRP (110/399, 27.6%). Significant decreases were shown in the incidence of physical injury and self-medical device breakage after restraint removal. There were no significant differences on the site, duration, or cause of physical restraints.
CONCLUSIONS
Although the IPRP education did not decrease the restraint application ratio, there were significant decreases on patient physical injuries and medical device breakage after restraint removal. We suggest that education should be performed continuously to both nurses and doctors to decrease the application of physical restraints.