Does access to bed‐chair pressure sensors reduce physical restraint use in the rehabilitative care setting?

Abstract

2 0 0 6 ) Journal of Clinical Nursing 15, 581-587 Does access to bed-chair pressure sensors reduce physical restraint use in the rehabilitative care setting? Background. The common use of physical restraints in older people in hospitals and nursing homes has been associated with injurious falls, decreased mobility and disorientation. By offering access to bed-chair pressure sensors in hospitalized patients with perceived fall risk, nurses may be less inclined to resort to physical restraints, thereby improving clinical outcomes. Aims and objectives. To investigate whether the access of bed-chair pressure sensors reduces physical restraint use in geriatric rehabilitation wards. Design. Randomized controlled trial. Methods. Consecutively, patients admitted to two geriatric wards specialized in stroke rehabilitation in a convalescent hospital in Hong Kong, and who were perceived by nurses to be at risk of falls were randomly assigned to intervention and control groups. For the intervention group subjects, nurses were given access to bedchair pressure sensors. These sensors were not available to control group subjects, as in usual practice. The trial continued until discharge. The primary outcomes were the proportion of subjects restrained by trunk restraint, bedrails or chair-board and the proportion of trial days in which each type of physical restraint was applied. The secondary outcomes were the proportions of those who improved in the mobility and transfer domains of modified Barthel index on discharge and of those who fell. Results. One hundred and eighty subjects were randomized. Fifty (55AE6%) out of the 90 intervention group subjects received the intervention. There was no significant difference between the intervention and control groups in the proportions and duration of having the three types of physical restraints. There was also no group difference in the chance of improving in mobility and transfer ability, and of having a fall. Ó 2006 Blackwell Publishing Ltd 581Conclusion. Access to bed-chair pressure sensor device neither reduced the use of physical restraints nor improved the clinical outcomes of older patients with perceived fall risk.Relevance to clinical practice. The provision of bed-chair pressure sensors may only be effective in reducing physical restraints when it is combined with an organized physical restraint reduction programme.

Ethical and practical concerns of surveillance technologies in residential care for people with dementia or intellectual disabilities: an overview of the literature

“…However, an extensive RCT study by Lauriks et al (2008) concluded that the residents with surveillance technologies had significantly fewer falls than those without. In another RCT study, Kwok et al (2006) concluded that technology (in the form of a bedchair pressure sensor) enhances supervision by nursing staff and may therefore prevent falls. Other research papers/case studies all report that the (multiple) devices they have either examined or designed have the benefit of reducing (potentially) harmful incidents (Blackburn 1988Gibson, 2003;Chen et al, 2007, Miskelly et al, 2004Schikhof and Mulder, 2008).…”

Use of Physical Restraints in a Rehabilitation Setting: Findings from a Point Prevalence Survey

“…Age was often reported to be one of the predictors of physical restraint usage in studies [33]. Locally, Kwok et al (2006) observed that around 79% of older adults in his sample were restrained at one time or another during their hospital stay [34]. Our restrained participants were also older in age.…”

Effect of Physical Restraint Reduction on Older Patients’ Hospital Length of Stay

“…Nevertheless, a previous attempt to reduce physical restraint by providing pressure monitors in 2 of these wards in the same hospital was not successful. 23 On this occasion, the program was led by the nurse in charge of the department and supported by the geriatricians and the hospital chief executive. The senior management also provided extra resources in providing electrical high low beds, pressure sensors, and shortened bed rails, which facilitated transfer.…”