Abstract
Introduction: Attitudes of nursing employees towards mechanical restraint are directly connected to their incidence. The purpose of this research was to examine the attitudes of psychiatric nursing staff towards the use and administration of mechanical restraints.Methods: The cross-sectional descriptive study was conducted using a structured Heyman-type survey. All the Slovenian nursing staff in psychiatric hospitals participated on a given day (n = 367).Results: Differences were observed in the average duration of administered mechanical restraint between individual hospitals (χ2 = 43.770, p < 0.001). Staff most often stated that patients felt angry when subjected to mechanical restraint (n = 328, 89.4 %). Nonetheless, the majority of respondents believe that mechanical restraints can be an effective therapeutic tool (n = 343, 91.6 %). Females (U = 11450.50, p = 0.025) and with higher education (U = 9527.00, p = 0.002) experience statistically significantly more negative emotions and are less inclined to use mechanical restraints.Discussion and conclusion: It is evident that in addition to the factors we researched some other factors are more influential when the incidences of coercive measures are closely studied. Due to some variation between hospitals it would be advisable to review the current clinical practices in this field. The management of health institutions should be considered an essential factor in the efforts to decrease mechanical restraint use.
Highlights
Attitudes of nursing employees towards mechanical restraint are directly connected to their incidence
The decision to use mechanical restraints is most often made by doctors, 273 (75.2 %), followed by health care assistants, 56 (15.4 %) and registered nurses, 33 (9.2 %)
The majority of respondents, 123 (56 %) assessed that the average duration of a mechanical restraint used on a patient is up to 4 hours; 46 (13.4 %) respondents assessed that the average duration of a mechanical restraint is up to 6 hours; and 105 (30.6 %) assessed that the average duration of a mechanical restraint is more than 8 hours
Summary
Attitudes of nursing employees towards mechanical restraint are directly connected to their incidence. While various forms of coercive measures are primarily used to ensure the safe treatment of patients who are considered at risk for auto- and hetero-aggression, and for the protection of health care employees, such measures entail the hazard of unexpected adverse events Since these events may be as severe as patient death, the use of coercive measures alone already has an indirect effect on stress of conscience, and the general well-being and satisfaction of psychiatric health care patients and staff (Stewart, et al, 2010; Strout, 2010; Gates, et al, 2011; Hollins & Stubbs, 2011; Berzlanovich, et al, 2012; Van der Merwe, et al, 2013; Whitecross, et al, 2013). The proportion of psychiatric nursing staff condoning the use of coercive measures remains very high (Gelkopf, et al, 2009)
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