title: Use of Physical Restraints in a General Hospital: a Cross-Sectional Observational Study.
abstract: BACKGROUND
  Physical restraints are a common, albeit controversial, tool used in the acute care setting.
  
  
  OBJECTIVE
  To determine the prevalence of physical restraint use in an acute care hospital. Secondary objectives were to determine whether physical restraints are used more commonly in night shifts, identify patient risk factors for physical restraint use, and establish if staff-to-patient ratio correlated with physical restraint use.
  
  
  METHODS
  An observational cross-sectional study was conducted over 3 months in 2013 in the medical, surgical and intensive care units in a mid-sized general hospital. All the physically restrained patients in each observation were added to the registry. At each observation one department was selected for comparison and all non-restrained patients were added to the registry.
  
  
  RESULTS
  The study population comprised 2163 patients. Seventy-six were restrained and 205 were included as case-controls. The prevalence of physical restraint use was 3.51% (95% CI = 2.79-4.37%). Physical restraint use was more common in night shifts than day shifts: 4.40% vs. 2.56% (P = 0.03). Male gender, dependency, invasive ventilation, invasive tubes (nasogastric tube or urine catheter), and bedsores were all significantly correlated with restraint use. Staff-to-patient ratios were not significantly correlated with use of physical restraints.
  
  
  CONCLUSIONS
  Physical restraints are relatively common in acute care wards. The use of physical restraints seems to correlate with certain patient characteristics but not with staff-to-patient ratios, and seems more common at night.
authors.forename: Barak
authors.initials: B
authors.lastname: Raguan
authors.forename: Efrat
authors.initials: E
authors.lastname: Wolfovitz
authors.forename: Efrat
authors.initials: E
authors.lastname: Gil
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors