The occurrence of physical restraint episodes in psychiatric settings is a major public
health issue because the therapeutic utility of this form of behavior control has
not been substantiated empirically. The purpose of this article was to examine the
extant literature to determine if evidence supports the conceptualization of a physical
restraint episode as an adverse client outcome that is sensitive to the organization
of nursing care in psychiatric settings. An adapted version of the Quality Health
Outcomes Model (Mitchell, P. H., Ferketich, S., & Jennings, B. M. (1998). Quality
Health Outcomes Model. Image Journal of Nursing Scholarship, 30, 43-46) was used as the conceptual model to guide this inquiry. The databases Cumulative
Index to Nursing and Allied Health Literature, Health and Psychosocial Instruments,
HealthSTAR/Ovid and Healthstar, Medline, and psychINFO were searched from 1990 to
2005. There are 101 sources in this review. Evidence strongly suggests that a physical
restraint episode is an adverse outcome that is sensitive to the organization of nursing
care. A systematic exploration of the specific structures and processes of the organization
that affect adverse outcomes, such as physical restraint episodes, is lacking in the
United States.
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Article info
Footnotes
This project was supported by a research fellowship from The National Institute of Nursing Research, National Institutes of Health (T32-NR-007104).
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© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
