Moving Beyond Resistance to Restraint Minimization: A Case Study of Change Management in Aged Care

Johnson, Susan L.; Ostaszkiewicz, Joan; O’Connell, Bev

doi:10.1111/j.1741-6787.2009.00162.x

Cited by 9 publications

(8 citation statements)

References 43 publications

(62 reference statements)

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“…These experiences can leave indelible imprints and inaccurate beliefs that require skilled facilitation of critical reflection for nurses to process and understand their related feelings and actions. Similar reactions and resistance to change were experienced by staff nurses implementing a restraint BPG for elderly patients (Johnson et al 2009). While the extensive literature exists related to generic facilitation of critical reflection (Moon 2008, Mezirow et al 2009), it has not been well discussed in the KT literature, nor included in the prominent KT models.…”

Section: Discussionmentioning

confidence: 72%

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Leading on the frontlines with passion and persistence: a necessary condition for Breastfeeding Best Practice Guideline uptake

Matthew-Maich

Ploeg

Jack

et al. 2012

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 72%

“…Similar reactions and resistance to change were experienced by staff nurses implementing a restraint BPG for elderly patients (Johnson et al . ). While the extensive literature exists related to generic facilitation of critical reflection (Moon , Mezirow et al .…”

Section: Discussionmentioning

confidence: 97%

Leading on the frontlines with passion and persistence: a necessary condition for Breastfeeding Best Practice Guideline uptake

Matthew-Maich

Ploeg

Jack

et al. 2012

Journal of Clinical Nursing

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“…Reluctance to eliminate these practices has also been reported elsewhere in Australia (Johnson et al . ) and the UK (Perkins et al . ).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Research on nurses' perceptions of containment practices in elder care has focused primarily on restraint use, where they have been found to resist elimination of this practice (Johnson et al 2009, Perkins et al 2012. A systematic review of studies of nurses' attitudes to physical restraint in elder care identified that while nurses have negative feelings towards its use, they perceive a need to retain this measure (Mohler & Meyer 2014).…”

Section: Introductionmentioning

confidence: 99%

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Nurses' experiences of restraint and seclusion use in short‐stay acute old age psychiatry inpatient units: a qualitative study

Muir‐Cochrane

Baird²,

McCann

2014

Psychiatric Ment Health Nurs

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Accessible summary• While the decision to use restraint and seclusion was not taken lightly, nurse participants felt that there were no effective alternatives to the use of these measures.• Adverse interpersonal, physical and practice environments contributed to the onset of aggression in old age psychiatry inpatient settings.• Policies to reduce or eliminate the use of restraint and seclusion need to take account of wide-ranging strategies to deal with aggression, including the provision of appropriate education and support and addressing ethical and workplace cultural issues associated with these practices. AbstractRestraint and seclusion are often ineffective and can affect patients adversely. In this study, we explored nurses' experiences of restraint and seclusion in short-stay acute old age psychiatry inpatient units and how these experiences underpin resistance to eliminating these practices. Qualitative interviews were conducted with nurses in three old age psychiatry units in Melbourne, Australia. The results provide one overarching theme, lack of accessible alternatives to restraint and seclusion, indicating that nurses believe there are no effective, accessible alternatives to these practices. Three related themes contribute to this perception. First, an adverse interpersonal environment contributes to restraint and seclusion, which relates to undesirable consequences of poor staff-to-patient relationships. Second, an unfavourable physical environment contributes to aggression and restraint and seclusion use. Third, the practice environment influences the adoption of restraint and seclusion. The findings contribute to the limited evidence about nurses' experiences of these practices in short-stay old age psychiatry, and how account needs to be taken of these experiences and contextual influences when introducing measures to address these practices. Policies addressing these measures need to be accompanied by wide-ranging initiatives to deal with aggression, including providing appropriate education and support and addressing ethical and workplace cultural issues surrounding these practices.

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Restraints and Immobility

Capezuti

Wagner

Reid

2012

Pathy's Principles and Practice of Geriatric Medicine

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Moving Beyond Resistance to Restraint Minimization: A Case Study of Change Management in Aged Care

Abstract: Recommendations are offered for dealing with change management processes in clinical environments, particularly the need to move beyond an individual mind-set to a systems-based approach for quality initiatives in residential aged care.

Cited by 9 publications

References 43 publications

Leading on the frontlines with passion and persistence: a necessary condition for Breastfeeding Best Practice Guideline uptake

Leading on the frontlines with passion and persistence: a necessary condition for Breastfeeding Best Practice Guideline uptake

Nurses' experiences of restraint and seclusion use in short‐stay acute old age psychiatry inpatient units: a qualitative study

Restraints and Immobility

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