The restraint chair: A qualitative study of nurses’ experience with the restraint chair versus four point restraint [2019]

• Emergency situations arise in psychiatric settings where safety is at risk.

• The restraint chair offers an alternative to four point restraint.

• This study examines the nurses’ experience with the restraint chair and four point restraint.

• Nurses note many benefits of the restraint chair over four point restraint.

Restraint and seclusion continues to be a challenging topic in psychiatric nursing care. While there is a movement toward reduction and elimination of restraint, emergency situations still arise that require intervention for the safety of patients and staff. In addition to traditional methods of restraint (physical holds, four-point restraint, seclusion), the restraint chair has been introduced at some hospitals as an alternative to four-point restraint. The restraint chair allows the patient to be upright in a seated position during the restraint process. Little research on the restraint chair currently exists. The purpose of this study was to examine the nurses’ experience with the restraint chair compared to four-point restraint. Results indicate nurses feel the restraint chair is easier to use, more humane, less traumatic, comforting, and enhances the therapeutic relationship compared to four-point restraint. Based on the reports of nurses in this study and prior quantitative work on the restraint chair (Castillo, Coyne, Chan, Hall, & Vilke, 2011; Visaggio et al., 2018), the restraint chair appears to be a safe and effective alternative to traditional four-point restraint. More research verifying these results at other hospitals in the United States and abroad is warranted.

Nicole Visaggio, Kathryn E. Phillips, Sharon Milne, Jeanne McElhinney, Scott C. Young
Archives of Psychiatric Nursing, Volume 34, Issue 1, February 2020