Interventions to Reduce the Use of Physical Restraints for Patients in Acute Care Hospital Settings: A Systematic Review

Purpose: This study aimed to systematically review and synthesize interventions designed to reduce the use of physical restraints in healthcare settings and to identify their key characteristics and outcomes.Methods: A systematic review of 13 studies was conducted using PubMed, MEDLINE, CINAHL, Embase, and Cochrane Central, covering publications up to August 2024. Randomized controlled trials and quasi-experimental studies were included. Risk of bias was assessed using RoB 2.0 and ROBINS-I, and a narrative synthesis was performed.Results: Interventions were categorized into three domains: hospital policies and education, tools and processes, and environmental or alternative strategies. Hospital-level policy changes, staff education initiatives, structured decision-making tools, mandatory documentation, physician orders, and regular multidisciplinary rounds were consistently associated with reductions in physical restraint use. Environmental modifications and alternative care approaches enhanced patient comfort and contributed to preventing the need for restraints. Across all included studies, restraint use decreased without a corresponding increase in adverse events.Conclusion: Interventions aimed at reducing physical restraint use in acute care hospitals, including policy change, staff education, multidisciplinary planning, structured decision-making tools, documentation practices, physician involvement, regular rounds, and environmental modifications, were consistently effective in decreasing restraint use without increasing adverse events. These findings support the clinical feasibility of such interventions and their effectiveness in maintaining patient safety and treatment stability.