From Policy to Culture: How Restraint-Free Care Became Organizational Practice in Long-Term Care Settings in South Korea.

Despite ethical concerns, physical restraint (PR) remains common in aged care. This study examines how "Restraint Zero" practices were developed and sustained in two South Korean facilities through a multiple case study. Using interviews with staff and leadership, we explored organizational strategies enabling PR elimination. Both sites implemented staff training, policy reforms, and cross-departmental collaboration to support personalized care. While workload increased, caregivers expressed pride in PR-Zero care, which upheld the dignity of both older adults and staff. Sustaining such efforts requires broader institutional and policy support to improve long-term care environments.