Nursing professionals’ attitudes toward use of physical restraints in Styrian nursing homes Austria

Pflege ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 57-63
Author(s):  
Hannes Mayerl ◽  
Tanja Trummer ◽  
Erwin Stolz ◽  
Éva Rásky ◽  
Wolfgang Freidl
Keyword(s):  
Nursing Homes ◽  
Large Scale ◽  
Critical Role ◽  
Physical Restraint ◽  
Care Practice ◽  
Physical Restraints ◽  
Convenience Sample ◽  
Restraint Use ◽  
Positive Attitudes ◽  
Nursing Professionals

Abstract. Background: Given that nursing staff play a critical role in the decision regarding use of physical restraints, research has examined nursing professionals’ attitudes toward this practice. Aim: Since nursing professionals’ views on physical restraint use have not yet been examined in Austria to date, we aimed to explore nursing professionals’ attitudes concerning use of physical restraints in nursing homes of Styria (Austria). Method: Data were collected from a convenience sample of nursing professionals (N = 355) within 19 Styrian nursing homes, based on a cross-sectional study design. Attitudes toward the practice of restraint use were assessed by means of the Maastricht Attitude Questionnaire in the German version. Results: The overall results showed rather positive attitudes toward the use of physical restraints, yet the findings regarding the sub-dimensions of the questionnaire were mixed. Although nursing professionals tended to deny “good reasons” for using physical restraints, they evaluated the consequences of physical restraint use rather positive and considered restraint use as an appropriate health care practice. Nursing professionals’ views regarding the consequences of using specific physical restraints further showed that belts were considered as the most restricting and discomforting devices. Conclusions: Overall, Austrian nursing professionals seemed to hold more positive attitudes toward the use of physical restraints than counterparts in other Western European countries. Future nationwide large-scale surveys will be needed to confirm our findings.

scholarly journals Physical Restraint Use in Swiss Nursing Homes: Two New National Quality Indicators

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 665-665
Author(s):  
Lauriane Favez ◽  
Franziska Zúñiga ◽  
Catherine Blatter ◽  
Narayan Sharma ◽  
Michael Simon
Keyword(s):  
Nursing Homes ◽  
Quality Indicators ◽  
Intraclass Correlation ◽  
Physical Restraint ◽  
Term Care ◽  
Convenience Sample ◽  
Systems Research ◽  
Restraint Use ◽  
National Quality ◽  
Standing Up

Abstract Quality indicators are used in nursing homes to assess physical restraint use. Switzerland introduced two publicly reported indicators measuring the use of 1) bedrails and 2) trunk fixation or seating that prevent standing up. Whether these indicators show good between-provider variability is unknown. The study aimed to measure the prevalence of physical restraint use and assess their between-provider variability using a cross-sectional, multicentre study of a convenience sample of nursing homes. The between-provider variability of the indicators was assessed with intraclass correlation 1 and with caterpillar plots based on Empirical Bayes estimates. We included 11,412 residents from 152 nursing homes. Prevalence rates were 13.5% (n=1’433) for bedrails and 3.6% (n=411) for trunk fixation / seating that prevent standing up. For the first indicator, intraclass correlation 1 was 0.245 (95%-CI 0.197-0.286), for the second 0.343 (95%-CI 0.235-0.405). The two indicators showed good between-provider variability and can be recommended for public reporting. Part of a symposium sponsored by Systems Research in Long-Term Care Interest Group.

Eliciting critical care nurses’ beliefs regarding physical restraint use

2018 ◽  
Vol 26 (5) ◽  
pp. 1458-1472 ◽  
Author(s):  
Gemma Via-Clavero ◽  
Marta Sanjuán-Naváis ◽  
Marta Romero-García ◽  
Laura de la Cueva-Ariza ◽  
Gemma Martínez-Estalella ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Theory Of Planned Behaviour ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Control Beliefs ◽  
Physical Restraints ◽  
Planned Behaviour ◽  
Restraint Use ◽  
And Control

Background: Despite the reported harms and ethical concerns about physical restraint use in the critical care settings, nurses’ intention to apply them is unequal across countries. According to the theory of planned behaviour, eliciting nurses’ beliefs regarding the use of physical restraints would provide additional social information about nurses’ intention to perform this practice. Aim: To explore the salient behavioural, normative and control beliefs underlying the intention of critical care nurses to use physical restraints from the theory of planned behaviour. Research design: A belief elicitation study was conducted. Participants and research context: Twenty-six critical care nurses were purposively sampled across gender, work-shift patterns and professional experience in five intensive care units of three hospitals in Spain. Data were obtained from a nine-item open-ended questionnaire and a focus group. Deductive content analysis was performed. Ethical considerations: Ethical approval was obtained from the hospital ethics committee. Participants were assured their participation was voluntary. Findings: Nurses framed the use of restraints as a way of prioritising patients’ physical safety. They referred to contextual factors as the main reasons to justify their application. Nurses perceived that their decision is approved by other colleagues and the patients’ relatives. Some nurses started advocating against their use, but felt powerless to change this unsafe practice within an unfavourable climate. Control beliefs were linked to patients’ medical condition, availability of alternative solutions, analgo-sedation policies and work organisation. Discussion: Safety arguments based on the surrounding work environment were discussed. Conclusion: Nurses’ behavioural and control beliefs were related. Nurses should be trained in alternatives to physical restraint use. The impact of analgo-sedation protocols, relatives’ involvement, leadership support and intensive care unit restraint policies on physical restraint practices need to be revised. Further research is required to explore why nurses do not act with moral courage to change this harmful practice.

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

2019 ◽  
Vol 40 (11) ◽  
pp. 2410-2428
Author(s):  
José-María Blasco ◽  
Celedonia Igual-Camacho ◽  
Francisco-José Pérez-Moltó ◽  
Pablo García-Molina ◽  
Juan Gómez-Salgado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Nursing Homes ◽  
Visual Analysis ◽  
Physical Restraint ◽  
Nursing Home Residents ◽  
Developed Countries ◽  
Physical Restraints ◽  
Rating Systems ◽  
Relevant Role

AbstractThis 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 and vice 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.

scholarly journals Psychometric Properties of the Persian Version of Perceptions of Physical Restraint Use Questionnaire

Salmand ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. 260-273
Author(s):  
Azam Sharifi ◽  
◽  
Narges Arsalani ◽  
Masoud Fallahi-Khoshknab ◽  
Farahnaz Mohammadi-Shahbolaghi ◽  
...  
Keyword(s):  
Older Adults ◽  
Factor Analysis ◽  
Content Validity ◽  
Structural Reliability ◽  
Physical Restraint ◽  
Physical Restraints ◽  
Persian Version ◽  
Restraint Use ◽  
Hospitalized Older Adults ◽  
Fit Index

Objectives: One of the fundamental responsibilities of nurses in care is to prevent harm to the patients and others. Many nurses use physical restraints to achieve this goal. Considering that the use of physical restraints in older patients is associated with physical and psychological complications and ethical issues, it is important to identify the nurses’ perceptions of using physical restraint in hospitalized older adults. This study aims to evaluate the psychometric properties of the Persian version of Perception of Physical Restraint Use Questionnaire (PRUQ) to be used in caring for hospitalized older adults in Iran. Methods & Materials: This is a methodological study with a descriptive cross-sectional design that was conducted in hospitals in Kermanshah (Western Iran) in 2019. After obtaining permission from the developers of PRUQ, translation to Persian was performed according to standard protocol of World Health Organization. Then, the Persian version was completed by 330 nurses who were selected by a convenience sampling method based on the inclusion criteria. Then, its face validity and content validity (qualitatively and quantitatively), construct validity using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), test-retest reliability, internal consistency and structural reliability were assessed. Statistical analysis was performed in SPSS v. 23 and AMOS v. 5 applications. Results: Results showed a Content Validity Index (CVR) of 0.78 and a scale CVI of 0.88. Based on the results of EFA and CFA, three factors were extracted including “prevention of fall”, “prevention of interruption or interference in treatment” and “providing safe environment”. The good fit of the three-factor model of the Persian PRUQ was approved based on the model fit indices (Chi square/degree of freedom=2.27, Goodness-of-Fit Index=0.83, Comparative Fit Index =0.91, Normed Fit Index=0.92, Root Mean Square Error of Approximation=0.08). The reliability of the questionnaire was confirmed by Cronbach's alpha coefficient (0.82), structural reliability (>0.70) and intraclass correlation coefficient (0.86). Conclusion: The Persian version of PRUQ has good validity and reliability to be used in nurses working in hospitals in Iran. It can be used in future studies in this population.

Nursing home performance in resident care in the United States: is it only a matter of for-profit versus not-for-profit?

2008 ◽  
Vol 3 (2) ◽  
pp. 115-140 ◽  
Author(s):  
FREDERIC H. DECKER
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Resource Dependence ◽  
Physical Restraint ◽  
Resource Dependence Theory ◽  
The United States ◽  
For Profit ◽  
Not For Profit ◽  
Resident Care ◽  
Restraint Use

Abstract:Poorer resident care in US for-profit relative to not-for-profit nursing homes is usually blamed on the profit motive. But US nursing home performance may relate to Medicaid public financing in a manner qualifying the relationship between ownership and quality. We investigated effects of Medicaid resident census, Medicaid payment, and occupancy on performance. Resource dependence theory implies these predictors may affect discretion in resources invested in resident care across for-profit and not-for-profit facilities. Models on physical restraint use and registered nurse (RN) staffing were studied using generalized estimating equations with panel data derived from certification inspections of nursing homes. Restraint use increased and RN staffing levels decreased among for-profit and not-for-profit facilities when the Medicaid census increased and Medicaid payment decreased. Interaction effects supported a theory that performance relates to available discretion in resource allocation. Effects of occupancy appear contingent on the dependence on Medicaid. Poorer performance among US for-profit nursing homes may relate to for-profit homes having lower occupancy, higher Medicaid census, and operating in US states with lower Medicaid payments compared to not-for-profit homes. Understanding the complexity of factors affecting resources expended on resident care may further our understanding of the production of quality in nursing homes, whether in the US or elsewhere.

scholarly journals Nurses’ Views on the Use of Physical Restraints in Intensive Care: A Qualitative Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9646
Author(s):  
Federica Canzan ◽  
Elisabetta Mezzalira ◽  
Giorgio Solato ◽  
Luigina Mortari ◽  
Anna Brugnolli ◽  
...  
Keyword(s):  
Intensive Care ◽  
Family Involvement ◽  
Care Setting ◽  
Physical Restraint ◽  
Intensive Care Setting ◽  
Physical Restraints ◽  
Structured Interviews ◽  
Psychosocial Effects ◽  
Restraint Use ◽  
The Many

Despite the worldwide promotion of a “restraint-free” model of care due to the questionable ethical and legal issues and the many adverse physical and psychosocial effects of physical restraints, their use remains relatively high, especially in the intensive care setting. Therefore, the aim of the present study was to explore the experiences of nurses using physical restraints in the intensive care setting. Semi-structured interviews with 20 nurses working in intensive care units for at least three years, were conducted, recorded, and transcribed verbatim. Then, the transcripts were analyzed according to the qualitative descriptive approach by Sandelowsky and Barroso (2002). Six main themes emerged: (1) definition of restraint, (2) who decides to restrain? (3) reasons behind the restraint use, (4) physical restraint used as the last option (5) family involvement, (6) nurses’ feelings about restraint. Physical restraint evokes different thoughts and feelings. Nurses, which are the professionals most present at the patient’s bedside, have been shown to be the main decision-makers regarding the application of physical restraints. Nurses need to balance the ethical principle of beneficence through this practice, ensuring the safety of the patient, and the principle of autonomy of the person.

scholarly journals Physical restraint of dementia patients in acute care hospitals during the COVID-19 pandemic: A cohort analysis in Japan

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260446
Author(s):  
Takuya Okuno ◽  
Hisashi Itoshima ◽  
Jung-ho Shin ◽  
Tetsuji Morishita ◽  
Susumu Kunisawa ◽  
...  
Keyword(s):  
Acute Care ◽  
Hospital Admissions ◽  
Cohort Analysis ◽  
Physical Restraint ◽  
Acute Care Hospitals ◽  
Physical Restraints ◽  
Restraint Use ◽  
Dementia Patients ◽  
Number Of Patients ◽  
The Impact

Introduction The coronavirus disease (COVID-19) pandemic has caused unprecedented challenges for the medical staff worldwide, especially for those in hospitals where COVID-19-positive patients are hospitalized. The announcement of COVID-19 hospital restrictions by the Japanese government has led to several limitations in hospital care, including an increased use of physical restraints, which could affect the care of elderly dementia patients. However, few studies have empirically validated the impact of physical restraint use during the COVID-19 pandemic. We aimed to evaluate the impact of regulatory changes, consequent to the pandemic, on physical restraint use among elderly dementia patients in acute care hospitals. Methods In this retrospective study, we extracted the data of elderly patients (aged > 64 years) who received dementia care in acute care hospitals between January 6, 2019, and July 4, 2020. We divided patients into two groups depending on whether they were admitted to hospitals that received COVID-19-positive patients. We calculated descriptive statistics to compare the trend in 2-week intervals and conducted an interrupted time-series analysis to validate the changes in the use of physical restraint. Results In hospitals that received COVID-19-positive patients, the number of patients who were physically restrained per 1,000 hospital admissions increased after the government’s announcement, with a maximum incidence of 501.4 per 1,000 hospital admissions between the 73rd and 74th week after the announcement. Additionally, a significant increase in the use of physical restraints for elderly dementia patients was noted (p = 0.004) in hospitals that received COVID-19-positive patients. Elderly dementia patients who required personal care experienced a significant increase in the use of physical restraints during the COVID-19 pandemic. Conclusion Understanding the causes and mechanisms underlying an increased use of physical restraints for dementia patients can help design more effective care protocols for similar future situations.

Physical Restraint: a descriptive study in swiss nursing homes

1998 ◽  
Vol 5 (4) ◽  
pp. 330-346 ◽  
Author(s):  
Virpi Hantikainen
Keyword(s):  
Nursing Homes ◽  
Nursing Staff ◽  
Physical Restraint ◽  
The Elderly ◽  
Descriptive Study ◽  
Physical Restraints ◽  
Next Of Kin ◽  
The Mean ◽  
Negative Sense

This article focuses on the reasons for using physical restraints, their prevalence and nurses’ experiences of their use. The data were collected by means of a questionnaire from nurses, trained nurse’s aids and auxiliary staff ( n = 173) in seven Swiss nursing homes. The results showed that physical restraints are used in nursing units, the mean number of restrained residents in each being 3.7 (SD 3.9). However, nursing staff did not necessarily understand and consider the term ‘restraint’ as a restrictive device in its negative sense. The most common reasons indicated for the use of restraint were related to the protection and safety of the residents themselves, the prevention of disturbance of other residents, and the residents’ restlessness and aggressiveness. As for the reasons related to staffing, reference was made to understaffing, a lack of competence on the part of nurses, and the demands of residents, their next of kin and doctors. It was not common practice to inform the elderly residents that they would be restrained, and therefore they were not always aware of what was happening to them and why. Twenty-nine per cent of the respondents reported that the flexibility of their work was affected by the use of physical restraint.

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