Characteristics of Nurse-Led Interventions to Minimize Physical Restraints in ICUs: A Scoping Review protocol

This project aims to conduct a scoping review to map and describe nurse-led interventions designed to minimize the use of physical restraints in adult intensive care units (ICUs). Physical restraint is frequently used in ICUs to prevent device removal and ensure patient safety; however, its use has been associated with adverse outcomes such as delirium, functional decline, and post-intensive care syndrome. Although clinical guidelines and policy statements emphasize restraint minimization, the implementation and characteristics of nurse-led interventions remain heterogeneous and have not been comprehensively synthesized. This scoping review will be conducted in accordance with the JBI Manual for Evidence Synthesis, and the completed review will be reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Using the Population–Concept–Context (PCC) framework, the review will include studies involving adult ICU patients, focusing on non-pharmacological, nurse-led, or nurse-involved interventions aimed at reducing or minimizing the use of physical restraints. Eligible sources will consist of experimental and observational studies, qualitative research, quality improvement initiatives, and practice reports. The review will systematically search multiple electronic databases, including MEDLINE (PubMed), CINAHL (EBSCOhost), the Cochrane Library, Ichushi-Web, and J-STAGE. Three reviewers will independently screen studies and extract data. Extracted information will be descriptively mapped to summarize intervention characteristics, targeted patient behaviors or conditions, and clinical contexts in which these interventions are implemented. The findings of this review will provide an overview of existing evidence and identify knowledge gaps to inform future research and the development of nurse-led strategies to support restraint minimization in adult ICUs.