Attitudes, Informed Consent Obtaining Rates and Feelings About Physical Restraint Use Among Nurses

Objective: The study determined 1) informed consent obtaining rates 2) reasons not obtaining informed consent, 3) feelings against physical restraint, 4) perceptions about patient rights among nurses and 5) patient and surrogate reactions against nurses who did not ask for informed consent. Material and Methods: This prospective study used descriptive, analytical and cross-sectional methods with 254 nurses working in intensive care units, neurosurgery wards, and emergency departments of four hospitals. The questionnaire consisted of open-ended questions and was applied by face-to-face interviews. Results: Most nurses (97.6%, n=248) used physical restraint without informed consent. The reasons, emotions, and complaint were as follows: if we ask for permission they get angry an behave aggressively to us (85.1%), patients have already harmed themselves" (83.1%), "do not understand even if I explain" (83.1%) and "no reason to ask since they will not give consent" (80.6%). Patients under physical restraint stated their complaints about nurses to administrators (48.40/o), "begged for not being tied/untied" (71.7%), "developed introversion" (43.3%), and developed "feeding and hydration problems" (7.9%). Surrogates "Asked reason for physical restraint at each visit and declined to accept it" (57.1%), "Left clinic crying when patient was physically restrained" (55.1%), and "Tried to find somebody they know in the hospital to get help to end physical restraint" (46.5%). Nurses stated that after physical restraint they were either relaxed or felt sorry. Conclusion: Obtaining informed consent protects patient rights before using physical restraint. Nurses, therefore, should be more pro-active for informed consent.