Preventing the use of physical restraints on residents newly admitted to psycho-geriatric nursing home wards: A cluster-randomized trial
Preventing the use of physical restraints on residents newly admitted to psycho-geriatric nursing home wards: A cluster-randomized trial
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DOI：
10.1016/j.ijnurstu.2008.03.005
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发表时间：
2009-04-01
影响因子：
8.1
通讯作者：
Berger, Martijn P. F.
中科院分区：
文献类型：
--
作者：
Huizing, Anna R.;Hamers, Jan P. H.;Berger, Martijn P. F.
背景：虽然迫切需要无约束护理，但预防或减少身体约束的随机临床试验数量有限。目的：调查教育干预措施的有效性，以防止新入住心理老年护理院病房的居民使用身体约束。设计：整群随机试验。地点：14个荷兰心理老年护理院病房。参与者：138名入住14个老年心理护理院的居民试验选择基线测量后的家庭病房，其中33名居民死亡或未获得知情同意。分析中共有 105 名居民。方法：疗养院病房被随机分配到教育干预组或对照组。教育干预包括护士教育计划和护士专家咨询。数据在干预后 1、4 和 8 个月收集。受过训练的盲人观察员在 24 小时内分四次测量身体约束的使用情况。使用最小数据集来确定居民的特征，例如他们的认知状态。结果：在研究期间，实验组和对照组在约束状态、约束强度、多重约束和约束类型方面没有发现统计学上的显着差异。干预后1个月，新入住实验病房的居民中有38%受到限制。双侧床栏是测试后 1 (24%)、测试后 2 (23%) 和测试后 3 (28%) 中最常用的约束装置，其次是测试后 2 和 3 中红外系统的使用。结论：教育计划与护士专家的咨询相结合并不能阻止对新入住精神老年疗养院病房的居民使用身体约束。尽管其他研究显示这些类型的干预措施对减少约束的有效性具有可喜的结果，但建议开发额外的干预措施来防止使用约束。 (C) 2008 Elsevier Ltd. 保留所有权利。
Background: Although there is an urgent need for restraint-free care, the number of randomized clinical trials oil preventing or reducing physical restraints has been limited.Objectives: To investigate the effectiveness of an educational intervention to prevent the use of physical restraints oil residents newly admitted to psycho-geriatric nursing home wards.Design: Cluster-randomized trial.Setting: Fourteen Dutch psycho-geriatric nursing home wards.Participants: 138 residents admitted to 14 psycho-geriatric nursing home wards after baseline measurement of the trial were selected, out of which 33 residents died or informed consent had not been obtained. A total of 105 residents were included in the analyses.Methods: The nursing home wards were randomly assigned to either educational intervention or control status. The educational intervention consisted of an educational programme for nurses combined with a nurse specialist's consultation. The data were collected at 1, 4 and 8 months post-intervention. The use of physical restraints was measured by blinded, trained observers on four separate occasions over a 24-h period. The Minimum Data Set was used to determine residents' characteristics, such as their cognitive status.Results: During the Study period, no statistically significant differences between the experimental group and the control group regarding restraint status, restraint intensity, multiple restraints and types of restraints were found. One month post-intervention, 38% of the residents newly admitted to the experimental wards were restrained. Bilateral bedrails were the most frequently used restraints at Post-test 1 (24%), Post-test 2 (23%) and Post-test 3 (28%), followed by the use of infrared systems at Post-tests 2 and 3.Conclusion: An educational programme combined with the consultation of a nurse specialist does not prevent the use of physical restraints on residents newly admitted to psycho-geriatric nursing home wards. Although other studies have shown promising results with the effectiveness of these types of intervention on restraint reduction, the development of additional interventions to prevent restraint usage is recommended. (C) 2008 Elsevier Ltd. All rights reserved.