Use of physical restraint in hospital patients: A descriptive study in a tertiary hospital in South Africa.
Sebastiana Z Kalula, Sabela G Petros
PMID 28155298WHAT IT FOUND
Among 572 patients visited in acute wards, 132 were restrained, mostly by bed rails.
Pressure sores were recorded in 9.1% of restrained patients. Only 39% of nurses knew a restraint policy.
Key findings
01Of 572 patients visited, 132 (23%) were restrained, and bed rails were used in 123 (93%) of them.
02Pressure sores were recorded in 12 (9.1%) restrained patients.
03Only 39% of nurses knew of a hospital restraint policy, and more than 90% of doctors were unaware of one.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional and only recorded patients found restrained during day shifts, so night-time restraint use and complications could not be assessed. Complications such as pressure sores were recorded, but the study cannot show they were caused by restraint. Patients were not interviewed, and families were not asked, so their experience of restraint was not captured. No reason for restraint was stated in half the records, and documentation of orders, monitoring and consent was poor. Staff answers were self-reported and may not match actual practice. The study was done in one tertiary hospital, so the findings may not apply to other settings.
The easy way to misread this
Do not conclude that restraint prevents falls or is safe because no falls were recorded in restrained patients. The study only looked at patients during day visits, did not follow them prospectively, and recorded pressure sores in 9.1% of restrained patients.