Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong Kong

Lee, Diana; Chan, Marie; Tam, Eric; Yeung, Wai-Song

doi:10.1046/j.1365-2648.1999.00880.x

Cited by 47 publications

(87 citation statements)

References 37 publications

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“…[10,26,27]] and nurses who opt to maintain their own sense of comfort and security over the autonomy and dignity of patients [e.g. [28]]. Nurses seem to have been identified as the crux of the problem in restraint use.…”

Section: Discussionmentioning

confidence: 99%

Nurses using physical restraints: Are the accused also the victims? – A study using focus group interviews

Lai

2007

BMC Nurs

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BackgroundTo date, the literature has provided an abundance of evidence on the adverse outcomes of restraint use on patients. Reportedly, nurses are often the personnel who initiate restraint use and attribute its use to ensuring the safety of the restrained and the others. A clinical trial using staff education and administrative input as the key components of a restraint reduction program was conducted in a rehabilitation setting to examine whether there were any significant differences in the prevalence of restraint use pre- and post-intervention. Subsequent to the implementation of the intervention program, focus group interviews were conducted to determine the perspective of the nursing staff on the use of restraints and their opinions of appropriate means to reduce their use.MethodRegistered nurses working in units involved in the study were invited to participate in focus group interviews on a voluntary basis. Twenty-two registered nurses (three males [13.6%] and nineteen females [86.4%]) attended the four sessions. All interviews were audio taped and transcribed verbatim. Other than the author, another member of the project team validated the findings from the data analysis.ResultsFour themes were identified. Participants experienced internal conflicts when applying physical restraints and were ambivalent about their use, but they would use restraints nonetheless, mainly to prevent falls and injuries to patients. They felt that nurse staffing was inadequate and that they were doing the best they could. They experienced pressure from the management level and would have liked better support. Communication among the various stakeholders was a problem. Each party may have a different notion about what constitutes a restraint and how it can be safely used, adding further weight to the burden shouldered by staff.ConclusionStudies about restraints and restraint use have mostly focused on nurses' inadequate and often inaccurate knowledge about the use of restraints and its associated adverse effects. These studies, however, fail to note that nurses can also be victims of the system. Restraint use is a complex issue that needs to be understood in relation to the dynamics within an environment.

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Section: Discussionmentioning

confidence: 99%

Nurses using physical restraints: Are the accused also the victims? – A study using focus group interviews

Lai

2007

BMC Nurs

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“…32 Nevertheless, various inner conflicts can also be observed among caregivers, such as frustration, ambivalence, and guilt feelings about the use of physical restraint. [33][34][35] …”

Section: Caregivermentioning

confidence: 99%

Use of physical restraint in nursing homes: clinical-ethical considerations

Gastmans

Milisen²

2006

J Med Ethics

134

140

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This article gives a brief overview of the state of the art concerning physical restraint use among older persons in nursing homes. Within this context we identify some essential values and norms that must be observed in an ethical evaluation of physical restraint. These values and norms provide the ethical foundation for a number of concrete recommendations that could give clinical and ethical support to caregivers when they make decisions about physical restraint. Respect for the autonomy and overall wellbeing of older persons, a proportional assessment of the advantages and disadvantages, a priority focus on the alternatives to physical restraint, individualised care, interdisciplinary decision making, and an institutional policy are the central points that make it possible to deal responsibly with the use of physical restraint for older persons in nursing homes.

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“…Although, historically, the use of physical restraints was rst challenged and reduced in European countries (Evans & Strumpf, 1989;Williams, 1989), the majority of the work on the topic has been conducted in the USA [for a historical overview see Castle & Mor (1998)]. The study on physical restraints in other societies is almost totally limited to reports about prevalence rates (Karlsson et al, 1996;Retsas & Crabbe, 1998) and nurses' experiences (Hantikainne, 1998;Karlsson et al, 1998;Lee et al, 1999;Molassiotis & Newell, 1996).…”

Section: Introductionmentioning

confidence: 96%

Perceptions regarding the use of physical restraints with elderly persons: comparison of Israeli health care nurses and social workers

Werner

2002

Journal of Interprofessional Care

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In view of the difficulty involved in decision-making regarding the use or removal of physical restraints and the recent pattern encouraging the use of interdisciplinary teams for elder care issues, the present study compared the perceptions of Israeli nurses and social workers in health care settings regarding the use of physical restraints. Data were collected from a convenience sample of 50 nurses and 69 social workers working in long-term and acute care settings. The findings indicated that participants in all professions attributed moderate to low importance towards the use of physical restraints. Social workers' perceptions were similar to those of nurses in psychiatric hospitals and slightly more favourable to the use of physical restraints than those of nurses in nursing homes. Patients' safety (as reflected in the scores of the items related to protecting an older person from falling and protecting an older person from pulling out a catheter) was the most important reason for using physical restraints for both groups. Increased attention should be given to the role of social workers as team members in the process of decision-making regarding the use or removal of physical restraints, especially as mediators between the elderly person, family members and staff members.

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Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong Kong

Cited by 47 publications

References 37 publications

Nurses using physical restraints: Are the accused also the victims? – A study using focus group interviews

Nurses using physical restraints: Are the accused also the victims? – A study using focus group interviews

Use of physical restraint in nursing homes: clinical-ethical considerations

Perceptions regarding the use of physical restraints with elderly persons: comparison of Israeli health care nurses and social workers

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