An exploration of the utilisation and impact of restraint practices in acute paediatric settings: A narrative review of global literature

Abstract

Purpose: The purpose of this paper will be to ascertain the underpinning reason for restraint use in the acute paediatric setting. In the UK, presentations for mental health-related needs within paediatric settings have increased. These admissions can be associated with patients with significant mental health and trauma histories who present with behaviours that challenge, risking exposure to higher levels of restrictive practice. Design/methodology/approach: A literature review was conducted across five databases, PsychINFO, EMCARE, EMBASE, MEDLINE and CINAHL. Search terms related to “paediatrics” and “restraint” were used. In all, 116 studies were screened with 78 studies being retrieved for analysis. A total of eight studies were included for review. All studies were quality assessed using the appropriate tool that adhered to each respective design. Findings: Five themes were extracted from the analysis and presented. These themes were identified as “restraint as part of the role of paediatric nursing”, “culture and attitudes”, “lack of guidance and agreed terminology”, “lack of other alternatives” and “training”. Restraint in paediatrics is unregulated not only in the UK but also globally. Positive behaviour support is highlighted as an approach for restraint reduction in paediatric settings. Originality/value: This literature review identifies a significant lack of research regarding restraint for young people with mental health presentations in the paediatric setting. This paper sets forth the need for future research both in the UK and globally.