Safeguarding patients while implementing mechanical restraints: A qualitative study of nurses and ward staff's perceptions and assessment.
Liv Bachmann, Solfrid Vatne, Ingunn Pernille Mundal
PMID 35178794WHAT IT FOUND
Staff on psychiatric wards described mechanical restraint as a last resort but lacked clear guidelines for monitoring patients while restrained.
They varied widely in checking vital signs and physical safety, often assuming doctors were solely responsible for these assessments.
Key findings
01Many participants were unaware of professional guidelines for how to check on patients during mechanical coercion, with some stating that department procedures only pertained to doctors.
02Staff practices for monitoring physical safety varied significantly, with some nurses stating they never felt it necessary to monitor blood pressure, pulse, or respiration rate during restraint.
03Decisions on when to release patients from restraints were described as subjective and based on individual discretion, as there were no clear templates or objective criteria.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included a small sample of 18 participants from only two wards in Norway, limiting transferability to other settings. Participants were recruited by nurse managers, which may have influenced who chose to participate. The findings reflect perceptions and self-reported practices, which may differ from actual clinical behaviour. The study did not include patient perspectives on the safety and comfort of the restraint process.
Declared interests
None declared.
The easy way to misread this
Do not interpret the lack of reported vital sign monitoring in this study as evidence that it is safe to omit these checks. The authors identify this variation as a significant safety concern and a gap in guidelines, not as an accepted or best practice.