• Clinical and Experimental Pediatrics
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• v.61 no.12
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• pp.381-386
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• 2018

Purpose: The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children. Methods: Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint systems and front seat use by children under six and 12 years of age, respectively. Results: The percentage of respondents who said they always use safety restraint systems increased from 17.7% in 2008 to 45.0% in 2015. The rate of children who did not use the front seats at all was 47.3 % in 2008 compared to 33.4% in 2015. Multivariate logistic regression analysis showed a decrease in safety-restraint-system use as age increased (odds ratio, 0.63; 95% confidence interval [CI], 0.51-0.77). The use rate of front-passenger seat belts by the mother is significantly correlated with the safety-restraint-system use rate by children (odds ratio, 2.14; 95% CI, 1.12-4.06). Conclusion: Although the rate of safety-restraint-system use for children is increasing annually, it remains low. Additionally, the use rate of front passenger seats for children is high. To reduce the rates of injury and death of children from traffic accidents, it is necessary to educate on the appropriate use of safety restraint systems according to age and body size and to develop stronger regulations.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.60-71
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• 2000

This research is a field investigation to collect basic information about the safe and efficient use of physical restraint in hospitals and for the ultimate minimization of restraint use. The objects of this study were sixty-four patients. They were restrained physically. Add their 32 family members, 24 nurses of two university hospitals in Seoul were also involved in the study. From April 16, to May 27, 1999. Research data were collected throughout the observation and interview process. Also, the data was analyzed using frequencies and field study notes that were invented by researchers. Results of this study were as follows: 1. According to the sex and age distinction; male's restraint use was 75%, female's was 25% and pre-schoolage children 39.1%, middle age 26.5%, and senior citizens 20.3%. According to the disease distinction; neuro-system was 35.9%, respiratory system was 21.9%. In the Ward, 40.6% of ICU patients were restrained and 39.0% of pediatric ward children were also to restraint. 70.3% of patients were restrained under 5days, while 10.9% were restrained 10days. 2. Types of physical restraints were wrist restraint (45.21%), arm board (35.62%), leg restraint (8.22%), chest restraint (6.85%), elbow restraint (2.74%) and mitten restraint (1.37%). 3. The percentage was 3.5%, which was in 64 restrained out of 1828 hospitalized people. At 1st investigation, the ratio was 3.5%, the 2nd was 3.0% and the 3rd was 3.9%. 4. The reasons of using the physical restraint were 'to protect implements' (72.84%), 'to protect patients' (18.52%), 'to protect an operative site' (8.64%). 5. The result of the patients; family and nurses' response analysis was: 'It seems to be safe', 'It uses properly', 'It is convenient for relatives and nurses', 'It is helpful to treatment', 'Objective think it is not restraint' were 79.9%. 'It is discomfort and stuffy', 'The implement is ineffective' were 21.1%. However in interview of the patients who can do verbally communication, 6 of 7 was responded that 'It is stuffy and uncomfortable'. 6. When restraint is used, the main decision is usually made by the nurses 42.2% of the time. The statistics read as thus: nurses and the physician in charge 31.3%, nurses and family 12.5%, physician's order 7.8%, only family 6.2%. Although the record of restraint was only 15.6% so that only 10 cases out of all the 26 ICU patients restrained. This study shows that physical restraints which of infringe independent-right of patients, are used without using criterion, explaining the agreement. Also, subjective decision of physician, nurses, and family make the decision of using restraint. So development of practice manuals and rules for restraint implementation is urgent.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.42-57
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• 2014

Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

• Korean Journal of Adult Nursing
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• v.19 no.4
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• pp.583-592
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• 2007

Purpose: The purposes of this study were to explore and describe the use of restraint on patients and to generate a grounded theory of how the use of restraint affects patients who have been restrained. Methods: Interview data from seven patients with physical restraint was analyzed using the Strauss and Corbin's grounded theory method. Data were collected and analyzed simultaneously. Unstructured and in-depth interviews were conducted retrospectively with patients recalling their memories of ICU following their transfer to general unit. Results: 'Safety belt' was emerged as a core category and it reflected that physical restraint provided a sense of security to patients. On the basis of core category, a model of the experience process of restrained patients in ICU was developed. The experience process were categorized into four stages: resistance, fear, resignation, and agreement. Stages of these proceeds appeared to have been influenced by the nurses' attitude and caring behavior such as the frequency of nurse-patient interaction, repetition of explanation, and empathetic understanding. Conclusion: These findings indicate that patients have mixed feelings towards restraint use, although negative feelings were stronger than positive ones. The result of this study will help nurses make effective nursing intervention.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.62-74
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• 2022

Purpose : This study aimed to identify the factors influencing physical restraint-related practice among nurses working in the intensive care unit (ICU). Methods : The participants consisted of 169 ICU nurses in three general hospitals in B and U cities. Data were collected from December 2021 to January 2022 through a structured self-administered questionnaire. Demographic characteristics, physical restraint-related practice, Person-centered Critical Care Nursing (PCCN), work environment, and attitudes toward physical restraint use were measured. For data analyses, hierarchical multiple regressions were conducted using SPSS/WIN 25.0. Results : Clinical careers in the ICU, better work environments, higher PCCN levels, and more positive attitudes toward physical restraint use were associated with a better practice of physical restraints, which together explained 35.5% of the total variance of the outcome. Conclusion : Our findings suggest that to promote a safe physical restraint-related practice among ICU nurses, it is important to improve the nursing environment, prepare guidelines for applying PCCN, and provide education for endorsing positive attitudes toward the use of physical restraints.

• Journal of the Korean Society for Aviation and Aeronautics
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• v.26 no.3
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• pp.93-104
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• 2018

It is mandatory to use car seats for infants and children in the private vehicles in accordance with the traffic law of Korea. Recently, legislation has also been proposed to expand the use car seats to express and intercity buses. This reflects a growing consensus that mandatory infant and child car seats, both for private and commercial vehicles, are essential. However, Korean laws concerning infants and children on board aircraft allow parents or guardians to hold children under two years of age on their laps without any restraint devices. It is not possible for a parent to physically restrain an infant or child, especially during a sudden acceleration or deceleration, unanticipated or severe turbulence, or impact. The use of CRS provides an equivalent level of safety to infants and children as that afforded to adult passengers wearing seat belts. But there is no regulation even about Child Restraint Systems on board aircraft in Korea. To enhance their safety, infants and children should be restrained in an approved child restraint system that is appropriate to their weight and height. It is necessary to examine whether infants and children in flight can achieve the same level of safety as an adult.

• Journal of Korean Academy of Psychiatric and Mental Health Nursing
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• v.27 no.4
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• pp.380-393
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• 2018

Purpose: The purpose of this study was to explore psychiatric nurses' decision making in the use of seclusion and restraint (SR). Methods: Data were collected using focus group interviews. Two focus group interviews were held with a total of 10 psychiatric nurse participants. All interviews were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: Eleven categories emerged from three main themes. All the themes describe factors that participants took into account when deciding whether to implement SR: 1) Personal factors area: 'Personal attributes of nurses,' 'Attitude of nurses regarding SR,' 'Nurses' physical and emotional states,' 'Negative experiences of nurses related to SR'; 2) Relational factors area: 'The level of cooperation between nurses and doctors,' 'Role models created by seniors and colleagues,' 'The level of support by nursing assistants,' 'Therapeutic relations with patients'; and 3) Environmental factors area: 'Poor nursing work environment,' 'Atmosphere of ward regarding SR,' and 'Social atmosphere to raise alarm about SR.' Conclusion: These findings should be considered in the evaluation of the use of SR in psychiatric hospital settings and appropriate strategies used to help minimize the use of restraint.

• 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.

• 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.