The effects of a physical restraint education program on the knowledge, attitudes, and behaviors of nursing staff

Background: Although the use of physical restraints (PR) is a very common strategy used in hospitals, this strategy poses significant psychological and emotional drawbacks. Moreover, nurses may feel guilt or overestimate the benefits of using PR. Previous studies have indicated that an education program may ameliorate patient safety and thus minimize the negative aspects of PR use. No hospital-based intervention study on this topic has previously been conducted in Taiwan.

Purpose: This study evaluates the effects of education programs on nursing staff in terms of improving PR-use knowledge, attitudes, and behaviors.

Methods: This quasi-experimental study used a pre-post testing research design and used purpose sampling to recruit nurses working at two teaching hospitals in northern Taiwan (N = 380). We used PR guideline handbooks for eight sessions and conducted an education program and a group lesson for 2 hours during one session. We adopted the scale of knowledge, attitude, and behavior of PR to collect data at baseline (T1), at four-week immediate post-program (T2), and at three months follow-up (T3). SPSS/PC 20.0 analyzed data using repeated measures ANCOVA.

Results: The intervention significantly improved knowledge (M = -7.13, p <.01) and altered both the attitudes toward PR use (M = -0.08, p <.001) and the behaviors toward PR use (M = -0.11, p <.01) of the participants in the first pre-post measurement. Additionally, the second pre-post measurement realized similar and significant improvements. The results indicate that, despite differences in length of work, unit of work, and participant ages, the PR intervention program significantly improved scores in knowledge, attitudes, and behaviors toward PR use.

Conclusions / Implications for Practice: A thorough education program may improve staff knowledge, attitudes and behaviors related to using PR. These findings may guide future hospital training by promoting knowledge on the use of PR in clinical settings.