Restraint Management

Antonelli, Mary T.

doi:10.1097/01.ncq.0000324587.53719.2f

Cited by 14 publications

(6 citation statements)

References 7 publications

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“…There is also evidence that patients with psychiatric illness such as bipolar disorder,40 dementia, or depression are at greater risk for delirium 41. The use of physical or chemical restraints in the treatment of delirium has been studied in other settings such as skilled nursing facilities42 and intensive care units,43 and restraint prevention programs have been suggested 44. Several studies have shown that most patients will be cooperative with an oral dosing regimen despite the belief that they may be too agitated or uncooperative 45.…”

Section: Discussionmentioning

confidence: 99%

A Research Agenda for the Assessment and Management of Acute Behavioral Changes in Elderly Emergency Department Patients

Shenvi¹,

Wilson²,

Aldai³

et al. 2019

WestJEM

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Introduction Agitation, mental illness, and delirium are common reasons for older adults to seek care in the emergency department (ED). There are significant knowledge gaps in understanding how to best screen older adults for these conditions and how to manage them. In addition, in areas where research has been performed, implementation has been slow. A working group convened to develop a set of high-priority research questions that would advance the understanding of optimal management of older adults with acute behavioral changes in the ED. This manuscript is the product of a breakout session on “Special Populations: Agitation in the Elderly” from the 2016 Coalition on Psychiatric Emergencies’ first Research Consensus Conference on Acute Mental Illness. Methods Participants were identified with expertise in emergency medicine (EM), geriatric EM, and psychiatry. Background literature reviews were performed prior to the in-person meeting in four key areas: delirium; dementia; substance abuse or withdrawal; and mental illness in older adults. Input was solicited from all participants during the meeting, and questions were iteratively focused and revised, voted on, and ranked by importance. Results Fourteen questions were identified by the group with high consensus for their importance related to the care of older adults with agitation in the ED. The questions were grouped into three topic areas: screening and identification; management strategies; and the approach to delirium. Conclusion It is important for emergency physicians to recognize the spectrum of underlying causes of behavioral changes, have the tools to screen older adults for those causes, and employ methods to treat the underlying causes and ameliorate their symptoms. Answers to the identified research questions have great potential to improve the care of older adults presenting with behavioral changes.

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Section: Discussionmentioning

confidence: 99%

A Research Agenda for the Assessment and Management of Acute Behavioral Changes in Elderly Emergency Department Patients

Shenvi¹,

Wilson²,

Aldai³

et al. 2019

WestJEM

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“…Five studies used a controlled study design: two studies were randomised controlled trials (one used a parallel-group design (Kwok et al, 2006) and one a stepped-wedge design (Enns et al, 2014)), two studies were nonrandomised controlled clinical trials (Lai et al, 2011(Lai et al, , 2013, and one study used a nonrandomised crossover design (Lever et al, 1995). We also found 11 pre-post studies (Amato et al, 2006;Antonelli, 2008;Beaulieu et al, 2008;Eskandari et al, 2018;Hanger et al, 1999;Hevener et al, 2016;Johnson et al, 2016;Köbke & Brase, 2017;Lin et al, 2018;Mion et al, 2001;Özdemir & Karabulut, 2009;Powell et al, 1989;Smith et al, 2003). All quality improvement projects used pre-post designs for evaluation, but the majority of publications did not provide detailed information about the study design.…”

Section: Characteristics Of Included Studies and Quality Improvemenmentioning

confidence: 76%

“…Sixteen publications reported on intervention studies (Amato, Salter, & Mion, 2006;Antonelli, 2008;Beaulieu et al, 2008;Enns, Rhemtulla, Ewa, Fruetel, & Holroyd-Leduc, 2014;Eskandari, Abdullah, Zainal, & Wong, 2018;Hanger, Ball, & Wood, 1999;Hevener, Rickabaugh, & Marsh, 2016;Johnson et al, 2016;Kwok, Mok, Chien, & Tam, 2006;Lai, Chow, Suen, & Wong, 2011Lever, Molloy, Bedard, & Eagle, 1995;Lin, Liao, Yu, Chu, & Ho, 2018;Özdemir & Karabulut, 2009;Powell, Mitchell-Pedersen, Fingerote, & Edmund, 1989;Smith, Timms, Parker, Reimels, & Hamlin, 2003) and 15 publications on projects (Cosper, Morelock, & Provine, 2015;Hall et al, 2018;Hancock et al, 2001;Jensen et al, 1998;Johnson & Beneda, 1999;Kirk, McGlinsey, Beckett, Rudd, & Arbour, 2015;Köbke & Brase, 2017;Markwell, 2005;Mion et al, 2001;Missildine & Harvey, 2000;Mitchell, Panchisin, & Seckel, 2018;Morrison et al, 2000;Rieth & Bennett, 1998;Swauger & Tomlin, 2000;Zoellner-Hunter, Goetz, & Czurylo, 2000) (see Tables 1 and 2). Articles were published between 1989 and 2018.…”

Section: Characteristics Of Included Studies and Quality Improvemenmentioning

confidence: 99%

“…Articles were published between 1989 and 2018. Most of the studies and projects (n = 20) were conducted in the USA (Amato et al, 2006;Antonelli, 2008;Beaulieu et al, 2008;Cosper et al, 2015;Hall, 2018;Hancock et al, 2001;Hevener et al, 2016;Jensen et al, 1998;Johnson & Beneda, 1999;Johnson et al, 2016;Kirk et al, 2015;Markwell, 2005;Mion et al, 2001;Missildine & Harvey, 2000;Mitchell et al, 2018;Morrison et al, 2000;Rieth & Bennett, 1998;Smith et al, 2003;Swauger & Tomlin, 2000;Zoellner-Hunter et al, 2000), three in Hong Kong (Kwok et al, 2006;Lai, Chow, Suen, & Wong, 2011 and…”

Section: Characteristics Of Included Studies and Quality Improvemenmentioning

confidence: 99%

“…The majority of the multicomponent interventions also included an educational component. In four studies and projects, education was offered to solely nursing staff (Amato et al, 2006;Antonelli, 2008;Hancock et al, 2001;Zoellner-Hunter et al, 2000), and in six studies to different healthcare professionals (Cosper et al, 2015;Enns et al, 2014;Kirk et al, 2015;Lai et al, 2011;Mion et al, 2001;Missildine & Harvey, 2000). In 13 studies and projects, the target group of the education was not described.…”

Section: Characteristics Of the Interventionsmentioning

confidence: 99%

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Interventions to reduce physical restraints in general hospital settings: A scoping review of components and characteristics

Abraham

Hirt

Kamm

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To describe the characteristics of interventions for reducing physical restraints in general hospital settings. Background Physical restraints, such as bedrails and belts in beds and chairs, are commonly used in general hospital settings. However, there is no clear evidence on their effectiveness but some evidence on potential risks for harm. Design Scoping review. Methods We conducted a systematic database search (MEDLINE via PubMed, CINAHL, Cochrane Library; March 2020) and snowballing techniques. We included both interventional studies and quality improvement projects conducted in general hospital settings and published in English or German language. Two reviewers independently performed the study selection and data extraction. The Scoping Reviews (PRISMA‐ScR) Checklist was used. Results We included 31 articles (published between 1989 and 2018), 15 quality improvement projects and 16 intervention studies. Only five studies used a controlled design. Most studies and quality improvement projects investigated multicomponent interventions including education (predominantly for nursing staff) and additional components (e.g. case conferences). Three studies examined simple educational programmes without additional components. Conclusions A large number of multicomponent interventions for preventing and reducing physical restraints in general hospital settings have been developed. The interventions differed widely regarding the components, contents and settings. Well‐designed evaluation studies investigating the effects of such interventions are lacking. Relevance to Clinical Practice Multicomponent educational interventions might be one approach to change clinical practice, but only insufficient information is available about potential effects of these approaches.

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Hospital-Acquired Injuries: Device-Related Pressure Ulcers, Falls, and Restraints

Bambi

2018

Nursing in Critical Care Setting

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Restraint Management

Cited by 14 publications

References 7 publications

A Research Agenda for the Assessment and Management of Acute Behavioral Changes in Elderly Emergency Department Patients

A Research Agenda for the Assessment and Management of Acute Behavioral Changes in Elderly Emergency Department Patients

Interventions to reduce physical restraints in general hospital settings: A scoping review of components and characteristics

Hospital-Acquired Injuries: Device-Related Pressure Ulcers, Falls, and Restraints

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