Experiences of intensive care nurses in their practice of physical restraint among patients: a qualitative study

Abstract

Introduction: Although physical restraint causes mental and physical harm to patients, such practice occurs worldwide to ensure patient safety. It is non-standard practice for a number of reasons, including the lack of education, training, and protocol. Objective: This study aims to determine the experiences of nurses who apply physical restraint to patients. Methods: A descriptive phenomenological method was employed in this study, wherein semi-structured interviews were the data collection method. In this qualitative study, the data consisted of semi-structured individual interviews with nurses (n = 20). The data were analysed phenomenologically and were arranged with MAXqda 22 analysis software. The study complies with the COREQ checklist. Results: Six main themes were found from the data. The themes were (i) experiences related to nurses' physical restraint procedures, (ii) ethical balance in nursing, (iii) nurses' emotions, (iv) the meaning of physical restraint, (v) nurses' observations regarding patients' reactions to physical restraints, and (vi) the experience of ethical dilemmas. The nurses perceived physical restraint as being uncomfortable, a necessity or an obligation, as beneficial for patients, and a practice seen as punishment. Conclusions: The findings showed that physical restraint elicited diverse thoughts and emotions among nurses, who reported difficulties in coping with these emotions and insufficient knowledge of restraint procedures. Nurses also described the need to protect patient safety while preserving patient autonomy, highlighting the ethical balance involved in decisions concerning physical restraint. Implications for Nursing Practice: This study has provided insight that can guide clinician nurses, educators, and policy-makers in improving physical restraint administration. The lack of knowledge held among nurses as to physical restraint procedures emphasizes the importance of education and training on this topic and can suggest areas of development for pertinent policies and guidelines. Patient or Public Contribution: No patient or public contribution.