Physical Restraint in the Critical Care Unit: A Narrative Review

New Bioeth. 2022 Mar;28(1):68-82. doi: 10.1080/20502877.2021.2019979. Epub 2022 Jan 27.

Abstract

Restraint has been used within health care settings for many centuries. Initially physical restraint (PR) was the method of choice, in present times. Within critical care units PR and chemical restraint are used, frequently in tandem. Restraint is not a benign intervention and PR specifically is associated with physical and psychological trauma towards those receiving it. Healthcare staff also suffer psychological consequences. This paper has reviewed the literature (using the terms 'physical restraint'; 'hospital'; 'care home critical care'; 'intensive care' 'attitudes'; 'knowledge' 'use of'; 'healthcare') to investigate the reasons for the use of restraints, its consequences and the attitudes of healthcare professionals' attitudes towards physical restraint currently present in critical care. Restraint use remains common practice in Critical Care Units (for 'patient safety'), initiated outside of institutional protocols, despite evidence questioning its effectiveness and the resulting harm to patients and staff.

Keywords: Critical Care; attitude; ethics; restraint.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel
  • Critical Care
  • Humans
  • Intensive Care Units*
  • Patient Safety
  • Restraint, Physical* / psychology