Attitudes of Dutch, German and Swiss nursing staff towards physical restraint use in nursing home residents, a cross-sectional study

Hamers, Jan P.H.; Meyer, Gabriele; Köpke, Sascha; Lindenmann, Ruth; Groven, Rald V M; Huizing, Anna

doi:10.1016/j.ijnurstu.2008.06.007

Cited by 72 publications

(99 citation statements)

References 23 publications

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“…In such situations, their autonomy was overruled, despite the fact that there was no danger to life or health. As previous studies have shown, 4,7,12,15,16,19,28 RNs using coercive measures had convinced themselves that residents' problematic behaviour was due to lack of insight, and therefore, constraints were seen as appropriate. It seems as though legal rights were understood as actions to prevent falls or harm, and not as actions to support autonomy and non-coercive dementia care.…”

Section: Discussionmentioning

confidence: 97%

“…Considering transferability, the results of this study may be applicable to other RNs, as they are in accordance with the previous knowledge of the cultural phenomenon of coercive treatment within nursing homes for people with dementia. 9,[15][16][17]19 …”

Section: Lejman Et Al 259mentioning

confidence: 99%

“…13 Various types of coercive measures, such as mechanical and non-mechanical restraint, compulsion to take part in nursing and medical treatments or activities of daily life (ADLs), seem to be common practice in institutional care in most Western countries. 7,[14][15][16][17][18][19] Coercive measures have been associated with severe adverse effects. 12,14,17,18 Despite coercive measures' harmful effect on quality of life, use of them is probably primarily based on lack of education and unawareness of alternative measures.…”

Section: Introductionmentioning

confidence: 99%

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The ethics of coercive treatment of people with dementia

et al. 2013

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The aim of the present study was to describe how registered nurses in nursing homes ensure legal security, good and safe nursing care and uphold the dignity of nursing home residents with severe dementia without violating residents' integrity. Semi-structured interviews were conducted with 10 charge nurses in a county in central Sweden. The transcribed interviews were examined using manifest and latent content analyses. The manifest analysis identified actual local routines involving coercive treatment and registered nurses' descriptions of complications and alternative measures. The latent analysis resulted in three themes describing nursing strategies: one with coercive treatment, one with coercive treatment under specific circumstances and one to prevent coercive treatment. Interpretations of legal terms regarding coercive treatment and inadequate gerontological nursing training and understaffing seem to preserve the use of coercive treatment.

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Section: Discussionmentioning

confidence: 97%

Section: Lejman Et Al 259mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The ethics of coercive treatment of people with dementia

et al. 2013

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“…Agitated patients may be constantly restless and some symbols such as mobility, pushing edge of the bed, taking invasive tools and cutters, trying to leave the bed, throwing and beating and may be due to not being aware of time and place (4). In cases that other actions are not possible, physical restraint seems to be one of the acceptable interventions to protect patients or personnel of the unit (8,9).…”

Section: Introductionmentioning

confidence: 99%

“…Although there is the primary tendency to use physical restraint to protect the patient, many negative and harmful effects of its use are reported (14). Use of physical restraint is accompanied by many complications and negative effects such as bed sore, depression and death (9); but improper and unprincipled use of physical restraint can create injury with different intensities sometimes leading to death (8).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Multifactorial Intervention on Observance of Physical Restraint Standards of the Patients Hospitalized in Intensive Care Units

Moradimajd¹,

Ali²,

Zolfaghari³

et al. 2016

Crit Care Nurs J

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Effect of a Guideline-Based Multicomponent Intervention on Use of Physical Restraints in Nursing Homes

Köpke¹,

Mühlhauser²,

Gerlach³

et al. 2012

JAMA

Self Cite

128

167

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Context Despite unambiguous legal regulation and evidence for lack of effectiveness and safety, physical restraints are still frequently administered in nursing homes.Objective To reduce physical restraint prevalence in nursing homes using a guideline-and theory-based multicomponent intervention. Design, Setting, and ParticipantsCluster randomized controlled trial of 6 months' duration conducted in 2 German cities between February 2009 and April 2010. Nursing homes were eligible if they had 20% or more residents with physical restraints. Using external concealed randomization, 18 nursing home clusters were included in the intervention group (2283 residents) and 18 in the control group (2166 residents).Intervention The intervention was based on a specifically developed evidencebased guideline and applied the theory of planned behavior. Components were group sessions for all nursing staff; additional training for nominated key nurses; and supportive material for nurses, residents, relatives, and legal guardians. Control group clusters received standard information. Main Outcomes MeasuresPrimary outcome was percentage of residents with physical restraints (bilateral bed rails, belts, fixed tables, and other measures limiting free body movement) at 6 months, assessed through direct unannounced observation by blinded investigators on 3 occasions during 1 day. Secondary outcomes included restraint use at 3 months, falls, fall-related fractures, and psychotropic medication prescriptions. ResultsAll nursing homes completed the study and all residents were included in the analysis. At baseline, 30.6% of control group residents had physical restraints vs 31.5% of intervention group residents. At 6 months, rates were 29.1% vs 22.6%, respectively, a difference of 6.5% (95% CI, 0.6% to 12.4%; cluster-adjusted odds ratio, 0.71; 95% CI, 0.52 to 0.97; P=.03). All physical restraint measures were used less frequently in the intervention group. Rates were stable from 3 to 6 months. There were no statistically significant differences in falls, fall-related fractures, and psychotropic medication prescriptions. ConclusionA guideline-and theory-based multicomponent intervention compared with standard information reduced physical restraint use in nursing homes.

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Attitudes of Dutch, German and Swiss nursing staff towards physical restraint use in nursing home residents, a cross-sectional study

Cited by 72 publications

References 23 publications

The ethics of coercive treatment of people with dementia

The ethics of coercive treatment of people with dementia

Effectiveness of Multifactorial Intervention on Observance of Physical Restraint Standards of the Patients Hospitalized in Intensive Care Units

Effect of a Guideline-Based Multicomponent Intervention on Use of Physical Restraints in Nursing Homes

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