Authors (including presenting author) :
Hui SLF(1), Chan NS(1), Yip LLV (1), LAI YFJ(1)
Affiliation :
(1)Central Nursing Division, Kowloon Hospital
Introduction :
Despite reports of mortality and numerous physical and psychological consequences associated with physical restraint, its use remains prevalent in healthcare settings to prevent falls, agitation, and self-harm. According to the HA prevalence survey (21/22), the rates are 20.69% in general and 9.4% in psychiatric settings. Decision-making regarding restraints is complex, involving not only information about consequences but also ethical considerations. Nurses must balance personal ethical values with professional judgment to minimize harm while respecting patients' dignity and rights. Factors such as culture and education influence nurses’ intuitive processes. Insights from experienced nurses about past patient encounters can help guide less experienced nurses in making informed decisions for better patient outcomes.
Objectives :
To improve clinical safety and patient outcomes by enhancing nurses' understanding of the physical and psychological impacts of restraint, fostering ethical decision-making, and promoting less restraint use through experiential learning and professional judgment development.
Methodology :
Two experiential workshops on physical restraint (PR) were organized on 19/9/2023 & 15/11/2023. One for APNs (11 no.) and one for junior nurses including ENs and RNs (12 no.). Each workshop was structured to have four parts. Starting with a 30 min lecture which provided some information about HA guideline, incident sharing and application devices currently using. After assessment on vital signs, there was a 15 min. short briefing about the experiential workshop – being restrained. The subject participant underwent a period of 30 min. restraint. Pre-PR and post PR questionnaire were done. Subsequently, a break and an intensive session of debriefing, reconciliation and evaluation.
Result & Outcome :
The results were positive. Subject nurses expressed undesirable feelings like fear and restlessness. Some reckoned this experiential workshop stimulated their rethinking about restraint. Awareness of applying physical restraint from the stand of patients and relatives. Some expressed worries, although they knew the limb holders would be released, still made them felt distressed.
Experiential workshop could help nurses to better understand the patients’ feeling and to stimulate their thinking and awareness about physical restraint and the impacts on patients. Although there were 23 clinical nurses participated. There sharing with other nurses would be valuable and hopefully to influence a culture of less restraint in practice.
