Interventions for preventing and reducing the use of physical restraints of older people in general hospital settings

Abraham, Jens; Hirt, Julian; Richter, Christin; Köpke, Sascha; Meyer, Gabriele; Mohler, R. Albert

doi:10.1002/14651858.cd012476.pub2

Cited by 10 publications

(6 citation statements)

References 68 publications

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“…A study assessing the association between surveillance technology and restraint found no significant relationship [68]. A recent review reported that physical restraint-free care is possible by creating environments that meet the needs of older people with mobility and cognitive impairments, and that promote patient safety [85]. This finding is supported by Evans and Cotter [73], who stated that reducing the use of physical restraint depends on a multitude of interventions.…”

Section: Discussionmentioning

confidence: 99%

Physical Restraint Use in Nursing Homes—Regional Variances and Ethical Considerations: A Scoping Review of Empirical Studies

2023

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Background: Physical restraints are known to violate human rights, yet their use persists in long-term care facilities. This study aimed to explore the prevalence, methods, and interventions related to physical restraint use among the elderly in nursing homes. Methods: The method described by Joanna Briggs was followed to conduct a scoping review without a quality assessment of the selected studies. An electronic search was conducted to find eligible empirical articles using MEDLINE, PsycINFO, EMBASE, Web of Science, Scopus, Google Scholar, CINAHL, and grey literature. The database search was performed using EndNote software (version X9, Clarivate Analytics), and the data were imported into Excel for analysis. Results: The prevalence of physical restraint use was found to be highest in Spain (84.9%) and lowest in the USA (1.9%). The most common device reported was bed rails, with the highest prevalence in Singapore (98%) and the lowest (4.7%) in Germany, followed by chair restraint (57%). The largest number of studies reported the prevention and/or risk of falls to be the main reason for using physical restraints, followed by behavioral problems such as wandering, verbal or physical agitation, and cognitive impairment. Most studies reported guideline- and/or theory-based multicomponent interventions consisting of the training and education of nursing home staff. Conclusions: This review provides valuable insights into the use of physical restraints among elderly residents in nursing homes. Despite efforts to minimize their use, physical restraints continue to be employed, particularly with elderly individuals who have cognitive impairments. Patient-related factors such as wandering, agitation, and cognitive impairment were identified as the second most common reasons for using physical restraints in this population. To address this issue, it is crucial to enhance the skills of nursing home staff, especially nurses, in providing safe and ethical care for elderly residents with cognitive and functional impairments, aggressive behaviors, and fall risks.

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Section: Discussionmentioning

confidence: 99%

Physical Restraint Use in Nursing Homes—Regional Variances and Ethical Considerations: A Scoping Review of Empirical Studies

2023

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“…The relatively high prevalence of use of physical restraints in Italy and Germany may have a negative effect on health outcomes such as emotional wellbeing and physical functioning while evidence for their effectiveness on for instance fall prevention is lacking. Use of physical restraints has been associated with increased risk of falls, a decline in physical functioning, pain, mental health problems, a higher risk of pressure ulcers, incontinence and injuries [ 38 – 41 ].…”

Section: Discussionmentioning

confidence: 99%

The prevalence of non-pharmacological interventions in older homecare recipients: an overview from six European countries

Kooijmans,

Hoogendijk,

Pokladníková

et al. 2023

Eur Geriatr Med

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Purpose Non-pharmacological interventions (NPIs) play an important role in the management of older people receiving homecare. However, little is known about how often specific NPIs are being used and to what extent usage varies between countries. The aim of the current study was to investigate the prevalence of NPIs in older homecare recipients in six European countries. Methods This is a cross-sectional study of older homecare recipients (65+) using baseline data from the longitudinal cohort study ‘Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care’ (IBenC). The analyzed NPIs are based on the interRAI Home Care instrument, a comprehensive geriatric assessment instrument. The prevalence of 24 NPIs was analyzed in Belgium, Germany, Finland, Iceland, Italy and the Netherlands. NPIs from seven groups were considered: psychosocial interventions, physical activity, regular care interventions, special therapies, preventive measures, special aids and environmental interventions. Results A total of 2884 homecare recipients were included. The mean age at baseline was 82.9 years and of all participants, 66.9% were female. The intervention with the highest prevalence in the study sample was ‘emergency assistance available’ (74%). Two other highly prevalent interventions were ‘physical activity’ (69%) and ‘home nurse’ (62%). Large differences between countries in the use of NPIs were observed and included, for example, ‘going outside’ (range 7–82%), ‘home health aids’ (range 12–93%), and ‘physician visit’ (range 24–94%). Conclusions The use of NPIs varied considerably between homecare users in different European countries. It is important to better understand the barriers and facilitators of use of these potentially beneficial interventions in order to design successful uptake strategies.

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“…Darüber hinaus sollten Barrieren zur Reduktion oder Vermeidung von FEM überwunden werden, wie das fehlende Wissen zu alternativen Versorgungsstrategien [ 21 ]. Da für das Krankenhaussetting keine wirksamen Interventionen vorlagen [ 22 ], orientierte sich die Modellierung der Intervention an einer komplexen Intervention, die in Deutschland für die stationäre Langzeitpflege entwickelt wurde und deren Wirksamkeit belegt ist [ 23 ].…”

Section: Komplexe Interventionenunclassified

Development and evaluation of complex interventions in nursing

Abraham

Mohler

2023

Bundesgesundheitsbl

Self Cite

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ZusammenfassungViele Interventionen in der Pflege sind komplex. Sie bestehen beispielsweise aus verschiedenen Interventionsteilen (Komponenten) und zielen auf Veränderungen von Prozessen oder dem Verhalten von Individuen oder Gruppen ab. Ein Rahmenmodell des britischen Medical Research Council beinhaltet methodische Empfehlungen für die Entwicklung und Evaluation von komplexen Interventionen. Diese narrative Übersichtsarbeit beschreibt die Umsetzung der methodischen Empfehlungen des Rahmenmodells am Beispiel von Interventionen zur Reduktion freiheitsentziehender Maßnahmen, z. B. Bettgitter oder Gurte an Stuhl und Bett, in der Krankenhaus- und der Langzeitpflege. Neben den Merkmalen der komplexen Interventionen werden die Entwicklung und theoretische Fundierung der Interventionen, die Prüfung der Machbarkeit und Wirksamkeit beschrieben.

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Interventions for preventing and reducing the use of physical restraints of older people in general hospital settings

Cited by 10 publications

References 68 publications

Physical Restraint Use in Nursing Homes—Regional Variances and Ethical Considerations: A Scoping Review of Empirical Studies

Physical Restraint Use in Nursing Homes—Regional Variances and Ethical Considerations: A Scoping Review of Empirical Studies

The prevalence of non-pharmacological interventions in older homecare recipients: an overview from six European countries

Development and evaluation of complex interventions in nursing

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