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Title: Knowledge, practice, and attitude of nursing home staff toward the use of physical restraint : have they changed over time?
Authors: Kor, PPK 
Kwan, RYC 
Liu, JYW 
Lai, C 
Keywords: Physical restraint
Nursing homes
Ethical issues
Long term care
Nursing staff
Issue Date: 2018
Publisher: Wiley-Blackwell
Source: Journal of nursing scholarship, 2018, v. 50, no. 5, p. 502-512 How to cite?
Journal: Journal of nursing scholarship 
Abstract: Purpose: Use of physical restraints is common in nursing homes, although empirical evidence has shown it to be a hazardous measure. This article aims to understand whether there were any changes in nursing home staff's knowledge, attitudes, and practices of using physical restraints in Hong Kong, after years of deliberation on this topic.
Methods: A questionnaire about the knowledge, attitude, and practice of using physical restraint was sent to all 298 staff members in four nursing homes in Hong Kong run by a nongovernmental organization. The results were compared with previous findings from 1999 using the same questionnaire.
Results: Overall, the staff had satisfactory knowledge of the daily application of physical restraints, such as the operational procedure and daily assessment. Concerning the conceptual knowledge of minimizing physical restraint use, their performance in the survey was less satisfactory. For example, only 6.6% of respondents were aware that residents had a right to reject the use of physical restraints, and 70% believed that there were no good alternatives to restraints. They showed appropriate attitudes in their practice of daily use of physical restraints. Compared with the previous study in 1999, a significant improvement was found in the attitudes (p = .0014) and practice (p = .0002) of using restraints, but there was no difference in their knowledge test results (p = .29).
Conclusions: The results of this study show a significant improvement among the nursing home staff in terms of their attitudes and practice of using restraints. In‐service training for nursing staff should focus more on their knowledge of ethical considerations and the hands‐on practice of using alternative devices (e.g., motion detectors or anti‐slip pads).
Clinical Relevance: The findings of this study suggest that in‐service training for nursing staff should focus more on their knowledge of ethical considerations, the principles of using physical restraint, and the alternatives to restraint in order to fill the knowledge gaps of staff and improve the quality of care in nursing homes.
ISSN: 1527-6546
EISSN: 1547-5069
DOI: 10.1111/jnu.12415
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