Date of Award

Fall 1994

Document Type

Thesis - Restricted

Degree Name

Master of Science (MS)




In the United States, the use of physical restraints in acute and long-term health care institutions has been a common practice. Physical restraints may be applied as many as 500,000 times each day across the United states, especially in providing care for patients over the age of 60 (Evans & Strumpg, 1989). The purpose of this qualitative study was to explore nurses descriptions of their perceptions regarding physical restraints and alternative treatments and the process that they utilize to make clinical decisions in relationship to restraints or alternatives. The grounded theory emergent fit mode design was selected for this study. Nine staff nurses who practice on two medical units of a midwest, urban, acute care hospital were interviewed using a semistructured approach. Constant comparative analysis was utilized. The clinical decision making themes which emerged from the data included: under-utilization of critical thinking, use of protective strategies, and lack of collaboration between nurses. The perception themes included: perception and decision incongruency and limited repertoire and use of alternatives. The data suggested that the nurses exhibited characteristics of oppressed group behavior. The results of this study have implications for nurse administrators and nursing research. Clinical decisions made by nurses and decisions made by nurse administrators are interrelated and impact on the practice of nursing, the quality of care provided for patients, and the legal, financial and accreditation status of the acute care hospital. A specific need is for nurse administrators to be knowledgeable about oppressed group characteristics and behaviors. Future research should examine questions that will determine what nurses need to participate in paradigm shifts related to clinical decision making for specific clinical issues such as the use of restraints.



Restricted Access Item

Having trouble?