Establishing Alternatives to Physical Restraint in the Acute Care Setting: A Conceptual Framework to Assist Nurses’ Decision Making

Critical care and acute care nurses must determine ways to deliver optimal patient care without the use of physical restraints. This article explores the application of the clinical decision analysis model to the challenge of finding nonrestraint approaches to care. Clinical decision analysis is a structured, quantified approach for choosing an optimal course of action in a situation that involves trade-offs among risks and preferences and when outcomes are uncertain. Decision analysis provides a graphic representation of the decision situation that facilitates evaluation of factors relevant to the situation and evaluation of the potential events and outcomes following a chosen strategy. The decision analysis model can be useful for determining guidelines for clinical practices, facilitating discussions among health care providers and patients, and determining areas in need of additional research.