Facility and area variation affecting the use of physical restraints in nursing homes.
Facility and area variation affecting the use of physical restraints in nursing homes.
复制标题
影响疗养院身体约束使用的设施和区域变化。
DOI：
10.1097/00005650-199611000-00008
复制
发表时间：
1996
期刊：
影响因子：
3
通讯作者：
Nennstiel,ME
中科院分区：
文献类型：
--
作者：
Phillips,CD;Hawes,C;Mor,V;Fries,BE;Morris,JN;Nennstiel,ME
目的：不同的个体特征增加了养老院居民被机械约束的可能性。然而，关于设施特征和地理区域在确定使用身体约束的可能性方面所起的作用，没有良好的信息。这项研究调查了个人、设施和区域指标在确定使用束缚的可能性方面的重要性。方法：他的研究使用了10个不同地区的250多家疗养院的2000名疗养院居民的数据。1990年，研究护士使用疗养院住院评估和护理筛选的最低数据集收集了住院数据。设施级别的数据是通过与设施工作人员的电话采访收集的。运用列联表和多元Logistic回归模型分析变量间的关系。结果居民的身体和认知功能、设施特征和地理位置的控制对约束行为有显著影响。那些护士人手较少的设施更有可能约束居民。此外，对这些因素的控制，约束措施在研究中的不同地理区域之间存在显著差异。结论与医院一样，疗养院在临床实践中表现出显著的设施间和地区差异。未来对养老院护理的分析可能会受益于更详细地考虑这两个因素。
OBJECTIVESVarious individual characteristics increase a nursing home resident's likelihood of being mechanically restrained. However, there is not good information on the role played by facility characteristics and geographic area in determining the likelihood of physical restraint use. This study investigates the importance of individual, facility, and area indicators in determining the likelihood of restraint use.METHODSThis research uses data on 2,000 nursing home residents receiving care in more than 250 nursing homes in 10 different areas. Resident-level data were collected in 1990 by research nurses using the Minimum Data Set for Nursing Home Resident Assessment and Care Screening. Facility-level data were gathered by telephone interviews with facility staff. The relations among the variables were investigated using contingency tables and multivariate logistic regression models.RESULTSControlling for residents' physical and cognitive function, facility characteristics and location had a significant impact on restraint practices. Those facilities with low nurse staffing were more likely to restrain residents. Furthermore, controlling for these factors, restraint practices varied significantly across the geographic areas in the study.CONCLUSIONSLike hospitals, nursing homes exhibit significant interfacility and regional variation in their clinical practices. Future analyses of nursing home care might benefit from considering both factors in much finer detail.