The use and prevention of procedural restraint in children - A scoping review.

Abstract

Problem: In healthcare facilities, restraint may be used on children to perform treatments or procedures. Restraint can be harmful, and little is known about how to prevent the use of restraint during medical procedures. A scoping review was conducted to find and map knowledge about (1) the use and prevention of restraint and (2) approaches, such as interventions and guidelines, available to prevent the use of restraint.

Eligibility criteria: This review was conducted following Arksey and O'Malley's framework, the JBI framework for scoping reviews, and the PRISMA-ScR (Protocol registration number GN5R3). Medline, EMBASE, PsycINFO, Epistemonikos, CINAHL, Cochrane Library were searched sept 2023. The search encompassed texts about children 1-18 years of age undergoing procedures conducted in non-psychiatric health care facilities.

Sample: The sample size was 2943 texts, and 288 texts met the inclusion criteria, of which 188 were considered research.

Results: Non-research texts consisted of reviews, demonstrations, opinions, and guidelines. The research lacked definitions of restraint though they described observations and attitudes toward restraint. Eight studies reported children's experiences. No evidence of how to prevent restraint was found, only reduction. Eleven guidelines were identified.

Conclusions: Few approaches have addressed how to reduce and prevent the use of restraints. Lack of a clear and united understanding and definition of restraint hinders the development of effective trials and guidelines.

Implications: Going forward, it is important to develop and explore approaches that build upon existing knowledge concerning restraint and positive procedural practice, including healthcare personnels competence, attitudes, and resources.