Reducing Inappropriate Restraint Use in Colorado’s Long Term Care Facilities

Palmer, Laura; Abrams, Fredrick R.; Carter, Diane; Schluter, W. William

doi:10.1016/s1070-3241(16)30429-1

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…More important, there is a need for continuing efforts and effective interventions to reduce nursing homes’ willingness to restrain their residents. A number of studies have demonstrated that a substantial reduction in restraint use combined with meaningful alternatives could result in no adverse outcomes or even positive benefits (Capezuti et al ., 1998; Neufeld et al ., 1999; Palmer et al ., 1999; Huizing et al ., 2006). Together with effective regulatory oversight, this can be achieved through innovative staff models and education programs specifically targeting restraint reduction.…”

Section: Discussionmentioning

confidence: 99%

Use of physical restraints and antipsychotic medications in nursing homes: a cross‐national study

Feng

Hirdes

Smith

et al. 2009

Int J Geriat Psychiatry

153

138

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SUMMARY Objectives This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Methods Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. Results The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6% in Switzerland, 9% in the US, 20% in Hong Kong, 28% in Finland, and over 31% in Canada. The prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26–27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. Conclusions There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates.

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Section: Discussionmentioning

confidence: 99%

Use of physical restraints and antipsychotic medications in nursing homes: a cross‐national study

Feng

Hirdes

Smith

et al. 2009

Int J Geriat Psychiatry

153

138

View full text Add to dashboard Cite

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“…Kültürel önyargılar, personel rol anlayışı ve hastane idaresinin tutumları gibi klinik olmayan faktörlerin yalıtım ve bağlama oranları üzerinde büyük bir etkisi olduğu bildirilmektedir (20). Yalıtım ve bağlama kullanımını gerektirecek durumları azaltacak pozitif ortam ve kültürler yaratmak veya uygun kültürel değişimi sağlamak için ülke çapında stratejilerin geliştirilmesi, kamu bilinci oluşturacak kampanyaların yapılması, yanlış inançları düzeltmeye yönelik eğitim programlarının düzenlenmesi tavsiye edilmektedir (8,59,66,67,71,72).…”

Section: Yalıtım Ve Bağlama Uygulamalarını Başarılı şEkilde Azaltan Punclassified

Psikiyatri Kliniklerinde Yalıtım Ve Bağlama Uygulamaları / Using Of Seclusion And Restraint In Psychiatry Clinics

Bilici¹,

Sercan²,

Tufan³

2013

Dusunen Adam

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Psikiyatri kliniklerinde yalıtım ve bağlama uygulamaları Psikiyatri kliniklerinde yatarak tedavi gören hastaların kendilerine, diğer hastalara veya hastane çalışanlarına yönelik zarar verici davranışlarına engel olmak amacıyla yalıtım ve bağlama (tecrit ve tespit) gibi kısıtlayıcı yöntemler uygulanmaktadır. Yalıtımın beklenen sonucu, tehlikeyi bertaraf etmek ve/veya hastanın ruhsal durumunun servisteki diğer hastalara katılabilecek kadar ilerlemesini sağlamaktır. Toplumlardaki yalıtım ve bağlama uygulamaları tarih boyunca dönemin kültürel özelliklerinden etkilenmiştir. Bu yazıda, ilk çağlardan günümüze kadarki yalıtım ve bağlama olaylarının kısa tarihçesi, uygulamanın gerekçesi, endikasyon ve kontrendikasyonları, uygulamaya bağlı komplikasyonlar gözden geçirilmiştir. Ayrıca yalıtım ve bağlama uygulamalarını azaltma girişimleri hakkında farklı ülkelerdeki uygulamalar gözden geçirilerek, başarılı olan programların öğelerine yer verilmiştir. Konuya ilişkin yasal düzenlemelere ve ülkemizdeki duruma da değinilmiştir.

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“…Au cours des dix dernières années, à la suite de la réforme OBRA, il y a eu émergence de publications d'interventions visant la réduction des contentions physiques dans les milieux de soins de longue durée aux Etats-Unis (Cohen, Neufeld, Dunbar, Pflug, & Breuer, 1996 ;Cruz, Abdul-Hamid, & Heater, 1997 ;Ejaz, Folmar, Kaufmann, Rose, & Goldman, 1994 ;Evans et al, 1997 ;Levine, Marchello, & Totolos, 1995 ;Middleton, Keene, Johnson, Elkins, & Lee, 1999 ;Moretz, Dommel, & Deluca, 1995 ;Neufeld, Libow, Foley, & White, 1995 ;Palmer, Abrams, Carter, & Schluter, 1999 ;Schott-Baer, Lusis, & Beauregard, 1995 ;Stratmann, Vinson, Magee, & Hardin, 1997 ;Sundel, Garret, & Horn, 1994 ;Werner et al, 1994). À notre connaissance, seulement deux interventions se sont déroulées au Canada.…”

Section: Programme D'intervention Visant à Réduire L'utilisation Des unclassified

“…Les interventions expérimentées ont souvent modifié les connaissances et les perceptions du personnel en regard des contentions physiques. En effet, l'efficacité perçue des contentions ainsi que leur désirabilité ressentie par le personnel se sont trouvées diminuées à la suite de programmes de réduction des contentions physiques (Bradley et al, 1995 ;Ejaz, Rose, & Jones, 1996 ;Evans et al, 1997 ;Middleton et al, 1999 ;Palmer et al, 1999 ;Sundel et al, 1994 ;Werner et al, 1994). Les connaissances du personnel soignant sur les solutions de remplacement à la contention étaient aussi meilleures après un tel programme (Bradley et al, 1995).…”

Section: Programme D'intervention Visant à Réduire L'utilisation Des unclassified

“…Les principales améliorations apportées par le programme sur les perceptions et connaissances du personnel soignant en regard des contentions physiques portent notamment sur leur définition, leurs conséquences néfastes, leur inefficacité et leurs motifs d'utilisation. En ce qui concerne leur définition, plusieurs auteurs ont observé qu'elles ne sont pas toujours reconnues comme telles par les soignants (Chien, 2000 ;Hagan-Hennessy, McNeely, Whittington, Strasser, & Archea, 1997 ;Palmer et al, 1999 ;Quinn, 1993 ). Dans l'étude de Chien (2000), l'utilisation de fauteuils gériatriques avec tablette n'était pas considérée comme une contention physique par la majorité des infirmières interviewées.…”

Section: Analysesunclassified

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Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant

et al. 2002

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This study aimed at (a) developing a restraint reduction program, (b) describing its implementation in long-term care units, and (c) examining its effects on care staff's perceptions of and knowledge about the use of restraints. The program was composed of three parts: consciousness-raising meetings, staff education, and clinical follow-up. The study was a randomized, controlled clinical trial with eight intervention care units (five nursing homes) and 11 controls (five additional nursing homes). Care staff was surveyed at two time intervals over a 7-month period (pre- and post-test intervention; intervention care units: N = 171 [T0] and N = 158 [T1]; controls: N = 181 [T0] and N = 166 [T1]). The implementation of the program was successful and results showed significant changes in care staff perceptions of and knowledge about the use of restraints.

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Reducing Inappropriate Restraint Use in Colorado’s Long Term Care Facilities

Cited by 10 publications

References 10 publications

Use of physical restraints and antipsychotic medications in nursing homes: a cross‐national study

Use of physical restraints and antipsychotic medications in nursing homes: a cross‐national study

Psikiyatri Kliniklerinde Yalıtım Ve Bağlama Uygulamaları / Using Of Seclusion And Restraint In Psychiatry Clinics

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant

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