No abstract

The purpose of this research utilization project was to select and implement a research-based Restraint Education Program for reducing the use of restraints in an acute care setting by changing the perception of the restraint coordinators about restraints in the direction of decreased importance. The Iowa Model, Research Based Practice to Promote Quality Care (Titler et al., 1994) was selected to guide the change process. A multidisciplinary team reviewed the restraint policy and procedure, new restraint products and alternative restraint methods. After a review of the literature on restraint education programs, the committee concluded that education was the key component in decreasing the use of physical restraints. The research-based Restraint Education Program developed by Drs. Strumpf and Evans was selected as the educational program. Education sessions were developed and a pilot study was conducted with the restraint coordinators. The Perceptions of Restraint Use Questionnaire (PRUQ) (Strumpf & Evans, 1988) was administered before and after the education sessions. The results of the t-test showed a decrease in the post-test mean scores on 7 of the 17 items indicating a less important perception by the staff about the use of restraints. Four items had an increase in mean scores on the post-test indicating the restraint coordinators increased their perception of the importance of physical restraints with these items. The restraint education program was presented to the nursing staff throughout the institution. Risk management and quality assurance will monitor patients restrained and evaluate the nursing staff with the PRUQ in 3 months.

TOPIC. The ethics of organ transplantation. PURPOSE. To heighten awareness on the use and misuse of harvested organs. SOURCES. Published literature. CONCLUSIONS. A sound public policy and clear guidelines on organ transplantatio~ are needed. Nurses involved in any aspect of organ transplantation need to be clear on the rights of the donor patients in order to advocate for them until their death.

The customer of health care is identified in different third-party financial reimbursement periods beginning with the period before Medicare. The author speculates that the customer in a managed care system might be the corporate offices where employee healthcare decisions are made. In a discussion of managed care, nurses are cautioned about the threats to patient welfare when institutional goals become the customer and take precedence over clinical outcomes of patients.