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  1. Shields, Lisa B. E. MD
  2. Edelen, Avalena MSN, RN, CCRN-K
  3. Daniels, Michael W. MS
  4. Flanders, Kimberly DNP, MBA, RN, NEA-BC


OBJECTIVE: To investigate the strategies implemented at our institution to reduce medical restraint use.


BACKGROUND: Restraints have been utilized to prevent agitation, self-extubations, and falls, although they are often associated with negative repercussions for nurses and patients.


METHODS: The restraint data at our institution were compared with the National Database of Nursing Quality Indicators (NDNQI) benchmark. We also described the measures taken to improve restraint documentation.


RESULTS: The number of patients in medical restraints, medical restraint hours, medical restraints/patient-days, and deaths in restraints at our institution all significantly decreased (P < 0.00001). There were 27 self-extubations of restrained patients compared with 11 self-extubations of nonrestrained patients. The percentage of inpatients with restraints in critical care and step-down areas declined and remained below the NDNQI benchmark.


CONCLUSIONS: This study reports the processes implemented to reduce restraint use through enhanced communication and increased documentation. Further exploration into factors that may attain a restraint-free environment is warranted.