The effects of physical restraint education on the knowledge and attitude of nurse interns

INTRODUCTION: The aim of this study was to determine the effect of training regarding the use of physical restraint of patients on the knowledge and attitude of nurse interns.
METHODS: This was an experimental study with a pre-test and post-test design. The population consisted of a total of 140 intern students attending the faculty of nursing of a single university in Turkey. Data related to demographic characteristics and experience were collected, and the respondents were also asked about alternative methods to physical restraint in an open-ended question during the pre-test phase. The Physical Restraint Knowledge, Attitude, and Practice Scale was used to assess the students before and after a nursing care management class that included physical restraint training.
RESULTS: Most of the nurse interns (63.6%) stated that they had experienced the use of physical restraint; most (29.3%) had encountered the practice in a psychiatry clinic. A majority of the students indicated that the content of the under-graduate education regarding physical restraint was not sufficient (65.7%) and that they did not know about alternatives to physical restraint (80%). The mean post-test scores in the knowledge, attitude, and practice subdimensions of the scale were significantly higher than the pre-test scores recorded prior to the training (p≤.001). There was a statistically significant increase in the following items: “Residents may refuse to be placed in a restraint”(p≤.001; x2=0.03), “If physical restraints are to be used, it is required to have signed consent from a member of the patient’s family”(p=0.002; x2=7.98), and “Restraints should be released every 2 hours”(p=≤.001; x2=13.49) in the knowledge subdimension. Higher scores were also seen in many attitude subdimension items, such as “I feel that family members have the right to re-fuse the use of restraints” and “I feel guilty placing a resident in restraints,” and in the practice subdimension, improved scores were seen in items such as “I try alternative measures before restraining a resident” and “When I restrain a resident, I make this decision only with a physician’s order” after the training.
DISCUSSION AND CONCLUSION: Detailed training on the use of physical restraint, including consideration of alternative techniques, rights, and legal aspects, significantly improved the knowledge and attitude the nurse interns. Additional observational studies of practice are recommended.