Physical Restraint Use in Acute Care Hospitals: A Diagnostic Study on Knowledge, Documentation, and Patient Safety from a Humanization Perspective

Background: The use of physical restraints in hospital settings remains a controversial practice due to its ethical, legal, and safety implications. Although restraints are intended to prevent falls or manage agitation, their inappropriate use may compromise patient dignity, autonomy, and quality of care. Current healthcare policies emphasize restraint reduction, proper documentation, and professional training as key elements of humanized and safe care. Methods: A descriptive, observational cross-sectional study was conducted in a tertiary university hospital to assess healthcare professionals’ knowledge, perceptions, and documentation practices related to physical restraint use. A structured anonymous questionnaire was distributed to nurses and nursing assistants (TCAE) working in adult inpatient units. The survey explored training, clinical decision-making, communication with patients and families, awareness of institutional protocols, and use of the electronic health record (EHR). Descriptive statistical analyses were performed using IBM SPSS Statistics. Results: A total of 241 professionals participated. More than half of respondents (54.8%) reported no formal training in physical restraints, and only 27.4% considered their training sufficient. Although 86.3% stated they were familiar with restraint indications, only 53.5% were aware of the existence of a structured EHR restraint registry, and just 31.0% consistently completed it. Documentation of restraint removal was particularly low (32.9%). Furthermore, significant discrepancies were observed between regulatory definitions of restraints and professionals’ perceptions of which practices require registration. Conclusions: This diagnostic phase reveals substantial gaps between regulatory requirements, professional knowledge, and real-world documentation of physical restraint use. The findings highlight the urgent need for structured training programs, standardized documentation processes, and institutional leadership to improve patient safety, regulatory compliance, and the humanization of hospital care.