Abstract

Introduction: Provision of care safely and in a secure environment is essential for patient improvement. Physical restraint in the intensive care unit is used to prevent disruption of patient care. However, an inappropriate use of physical restraint can have adverse physical, psychological, and social consequences on the patient. For the use of physical restraint, the nurses are key decision-makers and their knowledge, attitude and performance in relation to it play a key role in protecting the patient's safety. Purpose: The purpose of this study was to determine the knowledge, attitude and performance of nurses in intensive care units regarding the application of physical restraint of patients and their related factors in educational centers and hospitals affiliated to Guilan University of Medical Sciences in 2016. Procedure: 193 nurses of intensive care units of twelve educational centers of Guilan University of Medical Sciences participated in this cross-sectional research. Data were collected using a four-part tool consisting of demographic characteristics questionnaire, knowledge measurement, attitude and performance of nurses in intensive care units regarding the application of physical restraint of patients. Data was analyzed after encoding, by the use of SPSS software version 21 through descriptive and intuitive statistics. Data was described by using mean, standard deviation, median, and number and percentage. Spearman correlation coefficient was used to assess the relation of performance score with knowledge and attitude. Results: Results showed that 93.8% of nurses applied physical restraint and only 17.4% had a history of physical restraint retraining. Mean score of nurses regarding physical restraint was 11.04 ± 1.85, the mean score of nurses' attitude was 36.49 ± 5.02 and their mean performance was 36.95 ± 3.55. In this study, in terms of the regression of the non-homogeneous model, only the attitude score was considered as the performance-related predictor, so there was a significant positive relationship between attitude and performance scores (P = 0.001). So by increasing an average score of attitude, the average score of performance increases by 1.12 times (Odds Ratio: 1.12: CI. %95OR: 1.045-1.87). There is a meaningful relationship, in the regression of the matched model, between the attitude score and the performance score. (P = 0.003); so that by increasing the attitude score, the performance score increases by 1.1 times. (Odds Ratio: 1.12: CI. %95 OR: 1.048-1.19). Conclusion: The findings of the research highlights the need for in-service training courses for nurses and the allocation of lessons for nursing students from curriculum to include some subjects related to the safety and physical restraint of patients and increase in their ability to provide better clinical work.