Abstract
ABSTRACTThe aim of this study was to explore nurses’ and physicians’ perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care.We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway.The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities.The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.
Highlights
Children often undergo potentially painful and frightening medical procedures in hospitals and can experience distress, pain, and anxiety and may express strong and persistent resistance during procedures (Söderbäck, 2013)
The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint
This study explored restraint related to performance of a common medical procedure—insertion of peripheral vein cannulation (PVC) performed on newly admitted pre-schoolers in somatic hospital care
Summary
Children often undergo potentially painful and frightening medical procedures in hospitals and can experience distress, pain, and anxiety and may express strong and persistent resistance during procedures (Söderbäck, 2013). Peripheral vein cannulation (PVC), a common medical procedure, in an acute paediatric unit was used as the example in the exploration of healthcare providers’ perspectives and reasoning on restraint. There is a lack of clear and agreed terminology and nurses and allied healthcare providers differ in their description of their practices (Kirwan & Coyne, 2016; Page & McDonnell, 2013). It is uncertain if the terms cover the same or different aspects of what is going on (McGrath, Forrester, Fox-Young, & Huff, 2002).
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