Reducing Restraints: Where to Start

Abstract

To begin a restraint reduction program at a large neuropsychiatric Veterans Affairs medical center, nursing educators examined perceptions of and knowledge about restraint use among 113 nursing staff members employed on one acute, two intermediate, and five long-term care units. Strumpf and Evans' (1988) Perceptions of Restraint Use Questionnaire, a knowledge test, and questions about personal characteristics were used. Top reasons for restraint use identified were to prevent pulling on an intravenous line, to prevent breaking open sutures, and to protect from a fall. Although knowledge scores were high, they did not correlate significantly with ability to suggest alternatives. Respondents viewed restraint use as a somewhat important intervention. Statistically significant differences were found between level of practice and number of alternatives listed, knowledge score, and personal perception score. Implications for nursing educators embarking on a restraint reduction program are discussed including myths and quality-of-life issues.