From policy to practice: Transforming nurse competence through a restraint management recall program

Abstract

Background: Physical restraint (PR) involves the use of mechanical or physical devices to restrict a patient’s movement and is widely used in ICUs, wards, neurosurgery, psychiatry, and geriatric settings to prevent harm. Inappropriate or uninformed use may cause agitation, injury, delirium, or post-traumatic stress disorder.

Aim: To assess the effectiveness of a structured Restraint Management Recall Program in improving knowledge, attitude, and practice (KAP) regarding restraint policy among nurses.

Methods: A true experimental design was used, with 74 nurses in the experimental group and 57 in the control group (total n=131) from various departments (ER, ICU, OT, wards). Cluster sampling was applied. The intervention included a six-day
structured educational program (NCRACE modules) for the experimental group. Data were collected using a socio-demographic proforma, a structured knowledge questionnaire, and rating scales for attitude and practice, before and after intervention. The control group received regular CNE without the specialized program.

Results: Post-intervention, the experimental group showed a statistically significant improvement in KAP scores compared to the control group (p < 0.05). Knowledge sustainability was higher in the experimental group.

Conclusion: The Restraint Management Recall Program was effective in improving and sustaining nurses’ KAP regarding restraint policy, supporting its integration into regular nursing education programs.