Restraint Use in Acute Care Settings

The trend in healthcare is to use less restraint and to include patient freedom and respect as part of the quality care provided. Reducing restraint use in an acute care setting is a laudable goal, but the rising age of inpatients and their increasing acuity has made it difficult to meet this expectation. The following discussion addresses the problems of creating a less restrictive environment and the solutions that have been tried. It also contains a list of recommendations based on what is known and what needs to be accomplished. The discussion includes a review of the history and prevalence rate of restraint use, the attitudes of patients, staff, and families toward restraint use, nurses' knowledge about restraint use, the physical and psychological outcomes of being restrained, the ethical and legal implications of using restraints, the strategies used to reduce the use of restraints, and recommendations on how to create a less restrictive acute care environment.