• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.529-537
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• 2021

Although the use of physical restraints is controversial, it is still commonly used in hospitalized patients to prevent patient accidents in clinical practice. It is, therefore, necessary to evaluate the knowledge, attitude, perception, and nursing practices related to the use of physical restraints. This was a cross-sectional descriptive study in which self-administered questionnaires were collected from 144 nursing students at two Universities. Descriptive statistics, including t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression, were applied to analyze the data collected. Our results reveal that the mean knowledge score of nursing students regarding the use of physical restraints was 11.55±2.81, the mean attitude score was 60.01±7.24, the mean perception score was 59.97±10.68, and the mean nursing practice score was 38.04±4.15. Significant positive correlations were observed between nursing practice and knowledge, attitude, and perception. Multiple regression analysis showed that the factors significantly related to nursing practice and the use of physical restraints were perception (β=.23, p=.005) and attitude (β=.21, p=.009), having a total explained variance of 13.0%. The findings from this study suggest that perception is the strongest predictor of the use of physical restraints in nursing practice. Thus, it is necessary to develop and apply an evidence-based educational intervention program to ensure that nursing students correctly understand the need for physical restraints and later use them appropriately in clinical practice.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.167-174
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• 2019

The propose od this study was to examine the extent of using physical restraint on elderly patients (over 65 years old) and who were patients in long-term care hospitals. The data was collected, from March 3 2018 to March 29 2018, from the electronic nursing records by using a recording tool, and clinical observation was also used for assessing the use of physical restraint and the related factors. Descriptive statistics, Pearson correlation coefficients and logistic regression were then performed. The usage rate for physical restraints in long-term care hospital was 83.7%, and the most common type of physical restraint was side rails. The use of physical restraints showed a positive correlation with the fall risk scores and a negative correlation with the MMSE. Logistic regression analysis showed that the Fall Risk Score (OR=1.02, 95% CI=1.01~1.03), MMSE (OR=0.94, CI=0.88~0.99) and the use of medical devices (OR=0.80, 95% CI=0.65~0.98) were related with using physical restraints. Therefore, it was confirmed that physical restraint was used in cases of a high risk of falling, severe cognitive impairment and the use of complex and fragile medical devices to treat the patient. Clinical nursing practice should be changed so that treatment alternatives can be applied for elderly patients rather than using too many physical restraints.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.526-534
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• 2019

This study was undertaken to identify knowledge, attitude, perception and nursing practice toward use of physical restraints, among nurses in long-term care hospitals. We further explored the impact of factors associated with nursing practice toward use of physical restraints. This was a cross-sectional descriptive study in which self-administered questionnaires were collected from 128 nurses working at 11 long-term care hospitals. Descriptive statistics, including t-test, one-way ANOVA, Welch's test, Pearson correlation coefficients and multiple regression, were applied to analyze the data collected. Our results reveal that the participants possess moderate levels of knowledge, attitude, perception and nursing practice toward use of physical restraints. Significant positive correlations were observed between nursing practice and knowledge. Multiple regression analysis showed that the factors significantly related to nursing practice and use of physical restraint were knowledge (${\beta}=0.27$, p=0.002) and attitude (${\beta}=-0.17$, p=0.044), having a total explained variance of 9.0%. The findings from this study suggest that knowledge is the strongest predictor on nursing practice toward use of physical restraints. Thus, we propose that developing and applying evidence-based educational intervention programs to reduce the use of physical restraints in long-term care hospitals are required.

• Journal of Digital Convergence
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• v.15 no.12
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• pp.581-590
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• 2017

This study was conducted to investigate the perception of nurse's use of physical restraints. This study is a descriptive research study for 138 nurses who work at the small hospitals under 300 beds. Statistical analysis was performed using descriptive statistics, t-test, ANOVA, and factor analysis using the SPSS statistical program. The results of this study were as follows: The overall average of the nurses' perception of physical restraint was $3.91{\pm}0.54$, and the most important reason for using a physical restraint was to protect the patient from falling out of bed($4.37{\pm}0.68$). The factor analysis showed that 'behavior, psychological symptom management($3.81{\pm}0.67$)', 'maintain medical treatment($4.11{\pm}0.60$)' and 'patient safety($4.13{\pm}0.63$)'. It is necessary to understand the characteristics and factors of nurse's use of physical restraint in small and medium hospitals. Moreover, it is also required to use minimum physical restraints for patient's safeties and rights based on accurate understanding of physical restraint's use. Therefore, it is needed to provide job training for the physical restraint that is used in various situations and to develop education and intervention program to adjust in nurses' situation.

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.93-103
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• 2009

문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.

• Journal of Korean Academy of Nursing
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• v.39 no.6
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• pp.769-780
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• 2009

Purpose: The purposes of this study were to develop an educational program to reduce the use of physical restraints for caregivers in geriatric hospitals and to evaluate the effects of the program on cargivers' knowledge, attitude and nursing practice related to the use of physical restraints. Methods: A quasi experimental study with a non-equivalent control group pretest-posttest design was used. Participants were recruited from two geriatric hospitals. Eighteen caregivers were assigned to the experimental group and 20 to the control group. The data were collected prior to the intervention and at 6 weeks after the intervention through the use of self-administered questionnaires. Descriptive statistics, $\chi^2$ test, Fisher's exact probability test, and Mann-Whitney U test were used to analyze the data. Results: After the intervention, knowledge about physical restraints increased significantly in experimental group compared to the control group. However, there were no statistically significant differences between the groups for attitude and nursing practice involving physical restraints. Conclusion: Findings indicate that it is necessary to apply knowledge acquired through educational programs to nursing practice to reduce the use of physical restraints. User friendly guidelines for physical restraints, administrative support of institutions, and multidisciplinary approaches are required to achieve this goal.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.20 no.4
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• pp.345-358
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• 2013

Purpose: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. Method: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. Result: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. Conclusion: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.452-458
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• 2016

This is a descriptive study on visiting caregivers' perception of restraint use. Data were collected from 113 caregivers working at long-term facilities using a structured questionnaire from Feb to March 2016. The caregivers' perception of restraint use was the medium score. The items they considered the most important reasons for the restraints was "Protecting an older person from falling out of bed", which was primarily intended to prevent accidents of the elderly. The score of the knowledge of restraint use was 11.23 points out of 18 and those affected were more than 50 years of age. The attitude score to the use restraints was 9.19, and caregivers thought it should be possible to refrain from using restraints. Work experience of 3 years or less were higher. The perception of using restraints is affected by the knowledge and attitudes of restraint use. This is very important for the elderly in long-term care facilities and is related to health and human rights. Therefore, it is important to provide continuous education related to the use of restraints and regulations on their management.

• The Journal of Korean Academic Society of Nursing Education
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• v.15 no.1
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• pp.62-71
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• 2009

Purpose: The present study was performed to identify the perception, attitude, and knowledge regarding the use of physical restraints among nursing personnel working at long-term care facilities. Method: 289 nurses, nurse aids and private caregivers working at 13 wards from 7 facilities participated in the survey. Perception, attitude and knowledge regarding the use of physical restraints were evaluated using the Perceptions of Restraints Use Questionnaire developed by Evans and Strumpf(1993) and Physical Restraint Questionnaire suggested by Janelli, et al(2006). Results: Wrist restraints were used the most frequently. The perception score regarding the use of physical restraints was 3.35, which is a moderate value. Study respondents considered 'safety measure' and 'safe use of a medical device' as the most important aspects when applying physical restraints to elderly. The respondents reported physical restraints were therapeutic at least to some degree but knowledge level about physical restraints of the respondents was rather low. Conclusion: Perception and attitude toward physical restraints were identified. The lack in knowledge about physical restraints needs to be addressed for more efficient use of them.

• Journal of Digital Convergence
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• v.14 no.12
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• pp.503-513
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• 2016

The purpose of this study is to figure out family member's perceptions of side rail use in geriatric hospital by Cavanagh's content analysis with in-depth interview. This finding of the study suggests that the six themes of these perceptions are precautionary safety supervision, movement convenience, ritualistic nursing, physical restraint, danger of wounds, and alternative methods in an older person ward, and that the cause of recognized perceptions is not based on actual events, but rather on relatives' perceived protective value. With the transition of medical industry environment, there is a significant emphasis on efficacy and effectiveness of practice, risk management and evidence-based practice. However, the issue of side rail use and physical restraints remains unsolved in care of older people. Nurses claim the necessity of regimented protocol and clarification from professional organization regarding the side rail use.