• Gemma Via-Clavero, Joan Guàrdia-Olmos, Anna Falcó-Pegueroles, Diana Gil-Castillejos, Anna Lobo-Cívico, Laura De La Cueva-Ariza, Marta Romero-García, and Pilar Delgado-Hito.
• Intensive Care Department, Hospital Universitari de Bellvitge, Crtra, Feixa Llarga s/n. L 'Hospitalet de Llobregat, Barcelona, Spain; Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Pavelló de Govern, 3ºpl. 08907 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via, 199, 08908, L 'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: gviac@ub.edu.
• Aust Crit Care. 2020 Sep 1; 33 (5): 426-435.

BackgroundStudies addressing critical care nurses' practices regarding physical restraints have focused on individual nurses' knowledge and attitudes but lack the understanding of other social influences that could affect nurses' intentions to use them.ObjectiveThe objective of this study was to determine critical care nurses' attitudes, subjective norms, perceived behavioural control, and intentions to use physical restraints in intubated patients and the relationship between them and sociodemographic, professional, and contextual factors using a survey approach.MethodsA cross-sectional, multicentre study was conducted in a convenience sample of 12 intensive care units from eight hospitals in Spain (n = 354). The Physical Restraint-Theory of Planned Behaviour questionnaire and a researcher-developed survey were used to collect structural and clinical data from each unit. Multilevel model analysis was used.ResultsCritical care nurses showed a moderate level of intention to use physical restraints 12.52 (standard deviation = 3.81) [3-21]. More than a half (52%) agreed restraints were safe. The highest perceived barrier against physical restraint use was patient cooperation. Although nurses did not feel that others expected them to use restraints, they did not perceive high levels of disapproval of such practice. Nurses who had received previous training on restraints and who worked in units with a flexible family visitation policy, an informed consent form for restraint use, analgosedation and restraint protocols, and nurse-driven analgosedation management reported lower levels of intention to use restraints. Working in smaller units (beta -1.81; 95% confidence interval [CI]: -0.18, -3.44) and working in units with a consent form for restraint use (beta -4.82; 95% CI: -2.80, -6.85) were the variables with the highest impact on nurses' intentions to use restraints.ConclusionsCritical care nurses' intentions to use physical restraints are moderate and are influenced by intrapersonal, patient, and contextual factors. Nurses who work in units with organisational policies and alternatives to restraints demonstrated lower levels of intention to use them.Copyright © 2019 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

6 keywords...

hide…