Nurses' behaviours towards physical restraint use in the ICU: A descriptive qualitative study.

Aims and objectives: The study aims to explore and describe nurses' behaviours towards physical restraint (PR) use in intensive care units (ICUs) and identify key characteristics of these experiences. Background: Patients within the ICU are always vulnerable, which requires a thoughtful deliberation when employing PR in ethically laden situations. Considering that the qualitative study on nurses' behaviours towards PR use in ICUs is limited, a deep understanding of how nurses reason and restrict patients is necessary before developing a minimizing programme in hospitals. Methods: A descriptive qualitative study was conducted in this paper. Data were collected by 24 semistructured, in‐depth and individual interviews about PR, where 24 nurses were drawn from six ICUs of four hospital settings from a comprehensive tertiary care hospital in Qingdao. The QSR NVivo 11.0 software program was used to manage the interview data, and data analysis was guided by the Qualitative Analysis Guide of Leuven. The checklist of Consolidated Criteria for Reporting Qualitative Studies was followed as a guideline in reporting the study. Results: Regarding PR, nurses' behaviours start with a hazard perception, followed by hesitation about whether to restrict the patient. They would usually decide to apply PR when they think that no other choice to control the situation is available. Then, they would reflect on and rationalize their behaviours. Nurses, intensivists, patients and their families participate in and affect this process directly or indirectly. Conclusions: Nurses' behaviours towards PR use comprise a series of complex processes centred on safety. Nurses' decision making should be performed with the participation of intensivists, patients and family caregivers. SUMMARY STATEMENT: What is already known about this topic? The use of physical restraint (PR) is common in ICUs and is always a highly controversial topic.Nurses play a key role in PR practice.PR use from the perspective of nurses is rarely investigated in the literature. What does this paper add? Nurses' behaviours towards PR use comprise a series of complex processes centred on safety.In most cases, nurses' PR practice includes phases of perception, hesitation, implementation and reflection.Nurses, intensivists, patients and their families participate in and affect this process directly or indirectly. The implications of this paper: This paper provides a nuanced understanding of the complexity of nurses' behaviours towards PR use.The use of PR is never experienced as a single, fixed binding technique but a series of complex behavioural processes. Nurses, intensivists, patients and family caregivers contribute to the dynamic character of the practice.Taking targeted interventions from nurses, intensivists, patients and family caregivers is urgently needed to regulate PR application. [ABSTRACT FROM AUTHOR]