A Cluster‐Randomized Trial of an Educational Intervention to Reduce the Use of Physical Restraints with Psychogeriatric Nursing Home Residents

Abstract

An educational program for nursing staff combined with consultation with a nurse specialist (RN level) had no effect on the use of physical restraints with psychogeriatric nursing home residents. In addition to restraint education and consultation, new measures to reduce the use of physical restraints with psychogeriatric nursing home residents should be developed.

Preventing belt restraint use in newly admitted residents in nursing homes: A quasi-experimental study

“…The results of these studies are conflicting: some reported positive effects (Evans et al, 1997;Testad et al, 2005), while others found no effect (Evans et al, 1997;Huizing et al, 2006;Testad et al, 2010). Recent studies confirmed that education alone is not enough to ensure a reduction in the use of restraints (Huizing et al, 2009a;Pellfolk et al, 2010;Testad et al, 2010). The availability of alternative interventions seems to be an important additional prerequisite for eliminating restraint use (Becker et al, 2003;Capezuti et al, 1999;Freeman, 2004;Hoffman et al, 2003).…”

The more physical inactivity, the more agitation in dementia

“…It is still commonly argued that physical restraints protect patients and their environment from serious injury caused by aggressive behavior against others and autoaggressive behavior (Strumpf and Tomes, 1993;Hamers et al, 2004;Testad et al, 2010). Although there is no evidence for the beneficial effects of restraint use, these opinions clearly hinder the reduction or prevention of restraint use in clinical practice Huizing et al, 2009). However, evidence shows that when nursing home residents are being physically restrained, cognitive performance, mood and social engagement suffer (Castle, 2006).…”

Australian and New Zealand Society for Geriatric Medicine Position Statement Abstract: Physical restraint use in older people

“…The commonest type of restraint used in acute and residential care settings is still the bed rail [2][3][4][5][6][7].…”

“…These include wandering, aggression and interference with medical equipment. 3 The use of physical restraint in both acute and longterm care settings is not supported by evidence of efficacy or safety. Thus, the decision to use an intervention of little proven benefit, but which has the potential to cause harm, has clear ethical, legal and clinical implications.…”