A non-pharmacologic approach to decrease restraint use

Johnson, Kari; Curry, Valerie; Steubing, Alison; Diana, Shelly; McCray, Andrea; McFarren, Amanda; Domb, Alisa

doi:10.1016/j.iccn.2015.08.004

Cited by 34 publications

(42 citation statements)

References 26 publications

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“…These results can be correlated with a retrospective study in medical teaching units in Canada, which puts the incidence rate of chemical restraints at 10.3% [ 19 ]. Fear of falls and disruption of treatment were the most common indications for chemical restraints, which are consistent with the main reasons for restraint use in a study conducted to assess effect of education on use of restraints which were “protecting patients from falling of beds and chairs” [ 20 ].…”

Section: Main Textmentioning

confidence: 88%

Restraint use among selected hospitalized elderly patients in Cairo, Egypt

Eltaliawi¹,

El-Shinawi

Comer

et al. 2017

BMC Res Notes

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ObjectiveThis study’s primary objective was to investigate the prevalence of physical and chemical restraint use in selected elderly hospitalized patients.ResultsThis study was conducted in April 2014 in four major acute care hospitals. Trained data collectors assessed the use of physical and chemical restraint among all admitted elderly patients. There were 287 elderly patients (median age 64 years, 46% women). 32 patients were restrained. The overall prevalence of restraints was 11.1%, with physical restraint use alone at 3.2% and chemical restraints use alone at 7.3%. Restraint use varied by hospital type, with the highest at the private hospital (22.9%) and the lowest at the two university hospitals (< 6%). In conclusion the prevalence of physical and chemical restraint use among admitted elderly patients in Egypt is comparable to that seen in developed countries. However, the use appears to vary widely by hospital type. The use of restraints in the elderly remains an important question considering the increasing number of elderly.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2978-x) contains supplementary material, which is available to authorized users.

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Section: Main Textmentioning

confidence: 88%

Restraint use among selected hospitalized elderly patients in Cairo, Egypt

Eltaliawi¹,

El-Shinawi

Comer

et al. 2017

BMC Res Notes

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“…Another Canadian study presented that there is increased ICU nurses' knowledge after the advancing education of the evidence regarding restraint 24 through a PR training plan appeared statistically notable reduction in the use of restraint after one year 14 . Consequently, researchers concluded that program regarding PR with an educational component, restraint removal, individualized specific need, and interventions are the active components in lowering restraint use which revealed that educational programs had a positive impact on nurses' knowledge, attitude and practice regarding the use of PR 5,22,23,25,31,32 .…”

Section: 9%) Accompanying the Implementation Of A Programmentioning

confidence: 99%

Reducing Physical Restraint Use in Critically Ill Patients

Duwadi

Budal

Hua

2018

Int. j. endorsing health sci. res.

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Background: Patients in critical care setting often encounter severe delirium and agitation putting them at risk of harm. So it has become a common trend to restraint patient physically in intensive care units. However, physical restraint has several adverse physical, psychological and ethical consequences. Awareness regarding significant risk associated with physical restraint, continuing education and skills stabilize the patient's safety and potential complication regarding ethical and legal issues to physical restraint in critical care settings. This study aims to address if any alternatives have been tested regarding physical restraint to improve the patient care for critical care. Methodology: A search conducted using the PubMed, Medline and Google Scholar including physical restraint use in critical care setting from 1994 to 2017. Studies published in English were included whereas articles published in psychiatric care, children and outside the hospital were excluded. The keywords used were critical care, critically ill, ICU patient safety and physical restraint. The Boolean phrases were used to clarify the quality of search results: ''physical restraint & critical care,'' ''physical restraint & critically ill'' ''physical restraint & ICU,'' physical restraint & patient safety.'' Additionally, reference lists of selected papers were then evaluated further. Results: Enhanced knowledge, focused education and continuing training to improve skills in using restraint alternatives, awareness of the risk, early identification, conduct proper institutional policies and guidelines, and proactive intervention is the significant measures in alleviating physical restraint use in critical care settings. Conclusion: A restraint-free environment not only promotes patient safety but also ensure greater caregivers' job satisfaction reducing ethical issues.

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“…Among them, environmental modifications such as wheelchair adaptations and alternative seating, and alterations in the type of nursing care provided such as additional supervision and schedules to support residents with going to the bathroom, as well as more innovative proposals involving surveillance technology, have been applied (Zwijsen et al ., 2012). In this regard, the diverse proposals have shown different degrees of success (Haut et al ., 2009; Huizing et al ., 2009; Johnson et al ., 2016).…”

Section: Introductionmentioning

confidence: 99%

Use of physical restraint in nursing homes in Spain and relation with resident characteristics: a retrospective multi-centre cohort study with a self-organised maps approach

et al. 2019

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This is a retrospective cohort study based on data from five nursing homes which aims to appraise how physical and cognitive characteristics of nursing home residents were associated with the use of restraints, and to provide information on their prevalence in Spain. The goal was to assess, in a visual way, the possible interactions between the nursing homes residents’ characteristics and their association with the use of restraints. Motivation, risk factors, characteristics of the residents analysed by validated rating systems that assess mobility, level of dependence, cognitive condition and nutritional status, and their association with the use of restraints, were described by means of linear and non-linear multivariate approaches in the form of self-organised maps. Findings showed that the prevalence of restraints was high when compared to other developed countries. The visual analysis reinforced the knowledge that a greater impairment was associated with the use of restraints andvice versa. However, the residents’ characteristics were not always associated with the use of restraints. Subjective factors seem to play a relevant role in decision-making, so it is important to assess risk factors continuously and determine the actual need for the use of restraints from an individual perspective by basing the criteria on specific objectives, and on consistent, reproducible and reliable methods. Initiatives to minimise these subjective factors should be promoted. Likewise, a clear definition of physical restraints should be offered at each centre. In addition, effective legislation that clearly states the need, alternatives and motivation for the use of restraints is needed.

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A non-pharmacologic approach to decrease restraint use

Cited by 34 publications

References 26 publications

Restraint use among selected hospitalized elderly patients in Cairo, Egypt

Restraint use among selected hospitalized elderly patients in Cairo, Egypt

Reducing Physical Restraint Use in Critically Ill Patients

Use of physical restraint in nursing homes in Spain and relation with resident characteristics: a retrospective multi-centre cohort study with a self-organised maps approach

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