Nurses' use of physical restraints in four Turkish hospitals.
OBJECTIVE
(a) Determine the frequency and types of physical restraints used by nurses in intensive care units, emergency departments, and neurosurgery wards; (b) understand nurses' attitudes toward physical restraint; and (c) identify complications in physically restrained patients.


METHODS
This descriptive, cross-sectional study was carried out on 254 nurses working in intensive care units, emergency departments, and neurosurgery wards in four Turkish hospitals where physical restraints were used. The whole population was studied without any sampling, and data were collected via semistructured interviews from July 20 to September 6, 2005.


RESULTS
Nurses used either wrist, ankle, or whole body restraints at various levels. Those nurses who worked in surgical intensive care units and emergency departments and had in-service training used more physical restraint than did others. Only a third of nurses decided on physical restraint together with physicians and three-fourths tried alternative methods. Nurses reported edema and cyanosis on wrist and arm regions, pressure ulcers on various regions, and aspiration and breathing difficulties in relation to physical restraint. Moreover, they reported 9 deaths of patients in chest restraints. Reduction in the frequency of caregiving was related to complications.


CONCLUSIONS
Actions to reduce use of and complications from physical restraints should include attention to nurse staffing and education about use of restraints.
Demir
Ayten
A
Ankara University, Cebeci School of Health, Cebeci-Ankara, Turkey. aytendemir2000@yahoo.com
D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003657:Decision Making; D004509:Education, Nursing, Continuing; D004636:Emergency Service, Hospital / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training; D007362:Intensive Care Units / Q000458:organization & administration; D009493:Neurosurgery; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D010561:Personnel Staffing and Scheduling; D017009:Professional Autonomy; D012149:Restraint, Physical / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014421:Turkey; D016526:Workload