Physical restraints in the acute care setting: issues and future direction.

The pattern and prevalence of physical restraint in hospital settings have changed over the past decade. The challenge to health professionals who wish to reduce or eliminate the use of restraints includes clinical, ethical, and legal concerns. Factors that influence health care providers' decisions regarding whether to use physical restraints include organizational characteristics and systems of care, environmental characteristics, and specific clinical guidelines or protocols, as well as individual patient characteristics. To reduce the incidence of physical restraint, hospital professionals need to develop and test feasible alternative practices using an interdisciplinary approach that addresses organizational, environmental, and patient-specific factors.