The impact of education on the use of physical restraints in the acute care setting.
BACKGROUND
Physical restraints have become an acceptable standard of practice for managing safety and behavior control in acute care settings. Although the primary intent for using physical restraints is for patient protection, there are many negative outcomes related to their use. Heightened awareness by recent Joint Commission on Accreditation of Healthcare Organizations and the Center for Medicare and Medicaid Services standards for restraint use has led health care administrators and nursing staff to explore methods of reducing or eliminating the use of restraints. An educational program was planned and implemented for nursing staff emphasizing the risks of physical restraints and the benefits of innovative optional measures including nonrestraint devices. The program was tested to determine whether increased awareness through education would reduce the use of restraints.


METHODS
After current practice patterns and restraint utilization were established, a comprehensive educational program was provided to all nursing personnel. Twenty-three formal classroom inservice offerings were provided with follow-up reinforcement of self-study modules. Education included nursing assessment strategies and practical restraint optional interventions for managing patients exhibiting disruptive behaviors.


RESULTS
After the educational program, the overall use of physical restraints decreased as well as the length of time patients were restrained.


CONCLUSIONS
Results of this study reinforce the need to increase staff awareness and knowledge of nonrestraint interventions to manage disruptive behaviors in the acute care setting.
Smith
Nandel H
NH
Anderson Area Medical Center, Anderson, South Carolina 29621, USA.
Timms
Janet
J
Parker
Veronica G
VG
Reimels
Elaine M
EM
Hamlin
Ann
A
D000208:Acute Disease / Q000451:nursing*; D001291:Attitude of Health Personnel; D003479:Curriculum / Q000592:standards; D004509:Education, Nursing, Continuing / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training / Q000592:standards*; D015402:Nursing Education Research; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013022:South Carolina; D013997:Time Factors