The Relationships Between Critical Care Nurses' Experience, Decision-Making, and Their Attitudes Toward Physical Restraint Use

The purpose of this descriptive correlational study was to examine the relationships between and among registered nurses’ clinical experience, clinical decision-making processes, nursing practice issues with physical restraint use, and attitudes regarding physical restraint use in the critical care environment. The participants were 413 primarily white (91%), critical care nurses ranging in age from 19 to 68 (M=45.56) from across the United States. Participants were classified as experts based on Benner’s (2001) classifications, in both experience in nursing in general (88%) and in critical care (82%) in particular. Participants were recruited through the American Association of Critical Care Nurses (AACN) and completed two online surveys (Jenkins’ Clinical Decision Making in Nursing Scale (CDMNS) and The Physical Restraint Questionnaire – the Nursing Practice Issues with PR Use and Attitudes Toward PR Use subsections) via Survey Monkey™.

The results indicate that there is no strong correlation to explain any variance between attitudes toward PR use in critical care and clinical experience in nursing in general, clinical experience in critical care, clinical decision making, and nursing practice issues with PR use. This sample of nurses’ mean scores on the CDMNS were higher than noted in previous research. A moderate correlation was found between clinical decision making processes and nursing practice issues with physical restraint use. There were no differences found in any of the Benner stages of clinical experience. Nurses at all of Benner’s level from novice through expert had no significant differences in their attitudes toward PR use. Nurses with more clinical experience were more likely to have been taught content about PR use in their basic RN nursing curriculum then those with less clinical experience.

The results of this study suggest that there is a need to include education related to PR use in current nursing curricula which can lead to better clinical decisions and improved overall patient care related to PR use in critical care environments.