Even though controversial, physical restraints are usually used in adult significant care units in the United States to avoid treatment interference and self-inflicted harm. Use of physical restraints in hospitals is very limited. In the United States, an experimental design for research on use of restraints has not seemed feasible. However, international research provides an opportunity to compare and contrast practices. The use of physical restraints in acute and critical care settings in the United States and other countries has come under intense scrutiny in recent years. Despite the fact that often considered an acceptable standard of practice, the use of physical restraints is associated with physical, psychological, ethical, and legal problems. Restraints may be used to protect patients from a greater risk of harm, although evidence is lacking to support the effectiveness of using physical restraints to prevent treatment interference. Undesirable outcomes associated with use of restraints include the complications of immobility, emotional devastation, serious injuries, and death. Ethical concerns are related to patients' fight to autonomy and dignity, whereas the right to a safe working environment has been raised as an ethical justification for restraining disoriented and aggressive patients. (Elk, S., & Ferchau, L. (2000)
Alternative methods of running patients may be difficult to study experimentally. On the other hand, international and comparative research offers a design in which the safety of restraint-free care can be examined in various contexts. In an effort to explore the differences in practice between countries, the study to examine traditional use of physical restraints versus limited use or no use of restraints. Use of physical restraints became an acknowledged standard of practice in the United States during the early 1940s; restraints were described as "protective devices." With an emphasis on patients' safety and escalating technology in critical care environments, recommendations for the use of physical restraints abounded in the literature, reinforced by manufacturers' marketing of restraint devices as a method for keeping patients "safe." (Miles SH, Irvine P. 1992)..................
