Background: Physical restraints have become an acceptable standard of practice for managing safety and behavior control in acute care settings. Although the primary intent for using physical restraints is for patient protection, there are many negative outcomes related to their use. Heightened awareness by recent Joint Commission on Accreditation of Healthcare Organizations and the Center for Medicare and Medicaid Services standards for restraint use has led health care administrators and nursing staff to explore methods of reducing or eliminating the use of restraints. An educational program was planned and implemented for nursing staff emphasizing the risks of physical restraints and the benefits of innovative optional measures including nonrestraint devices. The program was tested to determine whether increased awareness through education would reduce the use of restraints. Method: After current practice patterns and restraint utilization were established, a comprehensive educational program was provided to all nursing personnel. Twenty-three formal classroom inservice offerings were provided with follow-up reinforcement of self-study modules. Education included nursing assessment strategies and practical restraint optional interventions for managing patients exhibiting disruptive behaviors. Findings: After the educational program, the overall use of physical restraints decreased as well as the length of time patients were restrained. Conclusion: Results of this study reinforce the need to increase staff awareness and knowledge of nonrestraint interventions to manage disruptive behaviors in the acute care setting.

Researchers conducted a retrospective review of 127 hospital records over a 3-month period to examine factors related to early hospital readmissions of patients age 65 and over. The leading diagnoses resulting in early readmissions were related to heart and circulatory problems, with a mean of 12.5 days between discharge and readmission. Gaps in documentation and the need for including qualitative data are discussed. Staff development educators are central to implementing strategies to correct these documentation deficiencies.

This descriptive research was conducted to determine perceived gerontological continuing education needs and priorities in the United Kingdom. The data collection questionnaire utilized was developed and previously implemented with gerontological registered nurses in the US. Findings and similarities from both samples are discussed. In the British study, a convenience sample of 123 gerontological registered nurses participated in the study. In the US study, a statewide random sample of 152 gerontological nurses and a purposive sample of 10 nurse experts completed surveys by post. All respondents were asked to rate either personal educational need or to rate the needs of nurses in general. In both the US and UK a degree of need was indicated for every topic on the survey, with little concensus of the top priorities. t-Test analysis (P < 0.05) revealed significant differences between general and personal perceptions for 75% of the topics in the UK study and 57% of the topics in the US study. A noteworthy finding in both studies was the consistent perception that educational need was greater for nurses in general than for personal need. The high level of identified need for educational preparation and the diverse perceptions regarding priorities, along with disparity in the personal versus general educational need, supports the need for future research to refine needs assessment strategies which may require a variety of strategies.

Questions periodically arise regarding clinical competencies and students' ability to perform in the employment setting after graduating from a baccalaureate nursing (BSN) program. This article describes a collaborative project between a nurse administrator in an acute care facility and a nurse educator in a baccalaureate nursing program. The project was designed to evaluate whether expected competencies of BSN graduates were evident in the work setting. Skills and behaviors of BSN graduates were evaluated by 68 nurses in an acute care setting. The findings provide data for nurse administrators to assist with planning staff development and continuing education programs for nursing staff. The results also provide data for nurse educators to assist with evaluation of effectiveness of nursing programs.