Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


Zvart Onanian School of Nursing



Date of Original Version



The use of restraints has been a controversial topic for decades in the healthcare field. Due to the fast paced and challenging environment in the acute care setting, there is frequent use of restraints when health care providers are faced with aggressive and threatening patient behavior. A review of the literature found that restraints can have many harmful physical and emotional effects. Several non-invasive alternatives as well as various de-escalation techniques to decrease restraint use have been proposed. The purpose of the systematic review was to identify the effectiveness of de-escalation strategies used to de-escalate aggressive behavior in adults over the age of eighteen with a previous psychiatric diagnosis in acute care settings. The Tidal Model is the conceptual framework serving as a guide for the research plan. A systematic review of randomized control trials was conducted to address interventions to prevent or de-escalate aggressive behavior in order to prevent the use of restraints and seclusion in acute psychiatric patients. The four studies analyzed in the systematic review demonstrated that non-invasive de-escalation techniques have been shown to decrease the incidence of aggressive behavior, seclusion, coercion and physical restraints. Recommendations for future practice include the need for further research and education as well as a standardized policy across the nation regarding the use of restraints in the acute care setting.

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