الفهرس 
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Abstract
The physical restraints as any method of physically restricting a person’s freedom of movement, physical activity, and normal access to the body. This encompasses many physical devices, such as wrist restraints, Jacket vests, and mittens.
Aim of the Study
Assess factors affecting nurses’ performance regarding use of physical restraint in critical care unit through the following:
1- Assessment of nurses’ knowledge regarding physical restraint.
2- Assessment of nursing practice regarding use of physical restraint.
3- Assessment of factors affecting nurses’ performance regarding use of physical restraint.
Research question:
Q1. What are the factors affecting nursing performance regarding physical restraint?
Research Design:
A descriptive exploratory design was used to achieve the aim of the current study.
Subject and methods:
Setting:
This study was conducted in the medical Intensive Care Unit (MICU) at Ain Shams University Hospital.
Sample:
A convenient sample of 36 nurses was recruited from the previously mentioned setting.
Study tools:
I-Self-administered questionnaire: used to assess nurse’s knowledge regarding caring for restrained patient which involves two parts, as follow:
1st part: It included demographic characteristics of nurses under study such as gender, age, and level of education and years of experience.
2nd part: It included 44 true and false questions concerned with assessment of nurses’ knowledge regarding definition of physical restraint, indication for use of physical restraint, types of physical restraint, complication of physical restraint and nursing care for patient with physical restraint.
II- Physical restraint observational checklist: to assess the level of nurses practice regarding use of physical restraints
Factors affecting nurses’ performance regarding use of physical restraint questionnaire: to assess the factors affecting nurses’ performance regarding use of physical restraint which consisted of 19 questions divided into two parts as follows:
Part 1: concerned with the nurses related factors.
Part 2: concerned with the hospital related factors.
Results:
The results of this study have shown the following:
That half of the studied nurses (50%) were between 20-30 years old, the lowest proportion for nurses (8.3%) were between 40-50 years old and about less than three quarters of them (72.2%) were females. less than half of them (44.4 %) had nursing experience from 10 to less than 20yrs. One third of them (33.3%) were between one to five years old and more than one third of them (41.7%) had an ICU experience above10 years. Two thirds of them (66.7%) were diploma nurses.
Fifty percentage of the studied nurses had satisfactory knowledge level and 50% of them had unsatisfactory level of knowledge
All the studied nurses (100%) had unsatisfactory level of practice regarding physical restraint specially nurses’ practice regarding preparation and documentation.
The factors affecting nurses performance regarding use physical restraints according nurses’ opinions is 72.2% of the studied nurses are feeling irritable when patient’s family enters the patient’s room when they are restraining the patient. 88.9% of the studied nurses reported that, they learnt about the physical restraints in the nursing course they studied. More than half of the studied nurses (61.1%) aren’t able to care for a large number of patients at the same time. The majority of the studied nurses (91.7%) believe that, the degree of experience is one of the most important factors affecting how to use physical restraints in a proper manner. Also 72.2% of the studied nurses see that physical restraint is an effective treatment to reduce the patient’s agitation and prevent health problems. Moreover, one third of the studied nurses (33.3%) believe that physical restraint is the best way to reduce the movement of the patient and prevent pulling the devices they are connected.
All of studied nurses reported that, the physical restraints should be applied based on written medical order, 63.9% of the studied nurses reported that, design of the ICU setting and separation of ICU patients’ in a private room affects their ability to monitor the behavior of the restrained patients. 41.7% of the studied nurses perform patient’s restraints without medical order in emergency situation. One third of the studied nurses (38.9%) reported that, the number of patients is large in relation to the number of the nurse. While, only 2.8% of the studied nurses reported the presence of clear policies to conduct physical, also reported that the hospital policy requires obtaining written consent for applying physical restraint from the patient or his/her family.
Conclusion:
It was concluded from this study that:
Based on findings of the present study, it can be concluded that, half of the studied nurses had satisfactory knowledge level regarding use of physical restraint. All of them had unsatisfactory level of practice. The most important personal factors affecting use of physical restraint is the degree of nursing experience, while the less reported factor is that the nurses consider the physical restraint as the best way to reduce the movement of the patient and prevent pulling out the devices. The most reported organizational factors include: design of the ICU setting and separation of ICU patients’ in a private room, absence of clear policies to conduct physical restraint accordingly, no written consent for patient’s approval on application of physical restraint, unavailable of all types of physical restraint and the hospital doesn’t imposes legal responsibility for nurses in case of patient’s harm due to use of physical restraint, in addition to absence of continuous education about use of physical restraint.