Physical restraint (PR) is the term used to describe limiting a patient’s motions and preventing them from moving around: Nursing Thesis, USM, Malaysia


Universiti Sains Malaysia (USM)

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Physical restraint (PR) is the term used to describe limiting a patient’s motions and preventing them from moving around freely either by attaching physiological or mechanical gadgets to the patient’s body or by using a brief physical force from the medical staff (Ye et al., 2019). In addition, Woldekirkos et al. (2021) stated that physical restraint is defined as any device, material, or piece of equipment that is attached to or adjoining to an individual’s body and that person cannot easily remove, immobilize, or restrict the individual’s ability to move their parts of the body freely and have normal access to their own body.

According to Lee, Välimäki, and Lantta (2021), these are frequently used in mental care settings. On occasion, they would be the only choice left to limit therapy interference and maintain patient safety. The main purpose of using physical restraints is to stop patients from hurting themselves or others. Additionally, they guarantee security, regulate agitation, control undesired behavior and aggressiveness, and guard against falls and accidents.

The use of physical restraint is a topic of intense dispute because it raises ethical and legal considerations that may harm patients’ autonomy and dignity. Physical restraint is only used as a last resort by medical personnel when all other measures have failed and the patient’s safety is in jeopardy, such as when they are at risk of falling, injuring themselves or others, yanking out tubes, or behaving aggressively or violently.

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Except for emergencies, multidisciplinary teams should debate each individual’s decision about restraint, involving the person and their family as much as feasible. Quality Improvement Standards on Restraint and Tranquility Crisis Intervention Training Program states that restraint or seclusion should only be used when it can be therapeutically justified or when patient behavior justifies it by endangering the physical patient’s safety, staff, or others.

Additionally, to ensure the patient’s, staff’s, or others’ physical safety, the hospital employs the least restrictive kind of restriction possible. The use of constraint, evaluation, and reevaluation of the patients who are restrained or sequestered, documentation of the use of restraint or solitude, and staff training to safely administer the use of restraint or solitary confinement must all be governed by written policies and procedures.

The Centers for Medicare & Medicaid Services and the Joint Commission have established the guidelines for applying physical constraints including the kind of device used for a patient’s PR, the circumstance under which to implement PR, the frequency of using physical restraint, the patient monitoring process, situations under which PR is released such as toileting or repositioning, as well as the measurable goals for the use of PR (CMS, n.d.). Countries and accreditation agencies have begun to encourage research that advocates for restricting the use of physical restraints due to advancements in patient rights over the past few decades.

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Physical conditions used incorrectly have the potential to be very harmful to patients. Patients who are exposed to physical constraints can die due to issues related to the circulatory system, the respiratory system, and incontinence, as well as pneumonia, constipation, and incontinence. Additionally, studies show that individuals who have been physically restrained undergo blood chemistry alterations in addition to behavioral and mental issues like fear, panic, fury, and rage.

Some of a nurse’s most important moral and legal obligations include maintaining a safe atmosphere and shielding patients from harm. For instance, protecting patients from falls and other accidents is a key sign of the quality of the care nurses offer.

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