Background: Physical restraint (PR) is one of the most common methods used by nurses to reduce patient movement, especially in Intensive Care Units (ICUs). However, PR is considered one of the undesirable methods due to its related clinical and ethical issues. This study aims to investigate Jordanian nurses' knowledge, attitudes, and practices regarding using PR and its alternatives in different ICUs, as well as its associated factors.

Methods: This is a descriptive-cross-sectional study, conducted in the ICUs of four different hospitals in Jordan from October 2013- March 2024. A Convenience sample of 240 ICU nurses was recruited to fill out a self-administered Physical Restraint Questionnaire (PRQ). Data were analyzed using independent sample t-test, ANOVA, or person-correlation as appropriate using SPSS 25.0. All conducted tests were two-tailed and considered significant when p-value <0.05.

Results: The results revealed moderate knowledge (11.1 ± 2.46), positive attitude (27.04 ± 3.35), and good practice (37.19 ± 3.33) regarding the use of PR. Receiving training on the use of PR had a direct significant relationship with the use of alternative methods before PR the patients (p < 0.001) and the total practice score (p = 0.049). The presence of PR as part of the new hire orientation program and the number of times of using PR had a significant association with the use of alternatives before PR the patients (p < 0.0001 & p = 0.043, respectively). In terms of total knowledge (p=0.01), use of alternatives (p=0.025) and practice (p<0.001) regarding the use of physical restraints, accredited hospitals were at a higher level, but the difference in nurses' attitudes was not significant (p=0.839).   There was a significant difference in terms of total alternatives (p=0.016), attitude (p<0.001) and practice (p=0.02) depending on the type of ICU. There were other significant relationships between the main variables among which the relationship between total knowledge and total practice (r = .434, p < .01), and total use of alternatives and total practice (r = .43, p < .01) were more powerful.

Conclusion: The current study indicates variations in nurses' knowledge levels, attitudes, and practice across different ICUs and hospital types. These findings emphasize the importance of in-service education as a golden role in improving nurses' knowledge levels and practices toward PR. The journey to accreditation in the management of hospital by nursing managers & policymakers has a positive impact on improving nursing knowledge and their skills regarding PR application and enhancing patient safety and care outcomes.