Semyon Melnikov and Yael Osher
Tel Aviv University, Tel Aviv, Israel
Wolfson Medical Center, Holon, Israel
Scientific Tracks Abstracts: J Nurs Care
Background: According to the Medical Administration's procedures in Israel, physical restraint (PR) is performed when otherwise a patient may inadvertently or unintentionally cause damage to him/herself or to others. However, PR detracts from patients' autonomy and personal dignity, deprives them of freedom, is coercive and may result in complications or even death. Understanding the factors that cause nurses to restrain patients may reduce use of PR. Purpose: To examine factors related to nurses' decision to restrain patients in general hospital. Methods: A cross sectional descriptive correlational study with a sample of 226 registered nurses from internal care and surgical departments at a tertiary general hospital in central Israel. A structured self-administered questionnaire measured: a) the number of PRs the nurse performed in the last month, b) the nurse's perception of using restraints, c) perceived departmental policy regarding PR use, d) the nurse's feelings during PR. Results: Of all participants, 64.2% reported having physically restrained patients at least once in the last month. Compared to nurses who did not restrain patients, those who did perceived PR as a means of patient protection, grasped departmental policy as being more supportive of PR, and had less negative feelings during PR. Nurses' perception of PR as a means of protecting patient, perceived departmental policy, and feelings of nurses during PR significantly explained 30% of the variance in PR in the last month. Conclusion & significance: Use of PR is an accepted and common practice. Among the reasons for the high incidence of PR: awarding PR high importance as a means of protecting patients, and nurses' perception of departmental policy as supportive of PR. Nursing administration must implement a policy of prudent use of PR and expand the use of PR alternatives.
Semyon Melnikov is a Lecturer in the Nursing Department in Tel Aviv University. Her research focuses on two main areas. In the first of these she attempts to clarify factors that affect the willingness and readiness of nurses to report for work and to function productively in emergency situations. A second theme of her research is examining knowledge and attitudes towards organ donation and transplantation. Recently she has started to work on a new area examining various ethical issues nurses meet in their everyday practice.
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