Perception of Spanish Nursing Staff on the Use of Physical Restraints

Authors

  • Emilio Fariña-López PhD, RN,

    Corresponding author
    1. Associate Professor, Nursing Department, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
    • Correspondence

      Emilio Fariña-López, Unidad Docente de Enfermería, Rafael Alberti 50, 35507, Tahiche, Lanzarote, Spain. E-mail: emilio.farina@ulpgc.es

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  • Gabriel J. Estévez-Guerra MSc, RN,

    1. Assistant Professor, Nursing Department, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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  • Manuel Gandoy-Crego PhD, BScPsych,

    1. Associate Professor, Nursing Department, University of Santiago de Compostela, Santiago de Compostela, Spain
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  • Luz M. Polo-Luque PhD, RN,

    1. Associate Professor, Nursing Department, University of Alcala, Alcalá de Henares, Spain
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  • Cristina Gómez-Cantorna PhD, RN,

    1. Assistant Professor, Nursing Department, University of Santiago de Compostela, Santiago de Compostela, Spain
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  • Elizabeth A. Capezuti PhD, RN, FAAN

    1. William Randolph Hearst Foundation Chair in Gerontology, Hunter College of the City University of New York, New York, NY, USA
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Abstract

Purpose

To examine the perception of registered nurses and nursing assistants regarding the use of physical restraints with residents of nursing homes located in four of the regions of Spain; and to evaluate the relationship of these perceptions to the staff respondents’ level of training.

Design

Cross-sectional multicenter and correlational study. The research was conducted in 2013 in 19 Spanish nursing homes with 2,940 residential beds. A total of 785 nurses (170 registered nurses and 615 nursing assistants) participated in the study.

Methods

The Perception of Restraint Use Questionnaire (PRUQ), consisting of 17 of the most cited reasons for using these devices, was used, as was a questionnaire capturing the sociodemographic characteristics and educational or experience level of staff respondents.

Findings

Nurses reported the most important uses for restraints as prevention of falls and avoidance of medical device interference. As indicated by an average PRUQ score of 3.47, staff respondents supported restraint use, especially nursing assistants (3.59) as compared to registered nurses (3.00). With regard to training: 83.7% had participated in little, if any, training and only 29.2% had read three or more documents related to restraint use; 66.6% believed that their training was inadequate. No correlation was found between the results of the PRUQ and the respondents´ sociodemographic characteristics or participation in training activities. No differences were found among nurses by region.

Conclusions

In contrast to papers published in other countries, nurses in this study still consider it necessary to apply restraints in everyday practice. The education of nursing staff regarding restraint and knowledge of alternatives is needed; they should at least be aware of international standards of care regarding physical restraint use.

Clinical Relevance

Most of the staff perceived their training related to the use of these devices as insufficient. Nursing assistants considered the use of restraints more important than did the registered nurses.

Ancillary