Restraint use in older adults in home care: A systematic review

Scheepmans, Kristien; Casterlé, Bernadette Dierckx de; Paquay, Louis; Milisen, Koen

doi:10.1016/j.ijnurstu.2017.11.008

Cited by 47 publications

(82 citation statements)

References 32 publications

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“…The developed multicomponent program has three main objectives: [1] to make the guideline more accessible and to disseminate it, [2] to increase awareness and knowledge of the problem of physical restraint use in home care, and [3] to work towards sustained implementation. Based on the theory-and evidencebased methods, the research group and expert panel selected and designed eight practical applications to operationalize those methods; i.e.…”

Section: Matrices Of Change Objectivesmentioning

confidence: 99%

“…Despite the harmful effects of restraint use on older persons, family caregivers and professional care providers, restraints are still frequently used in home care (1,2). A recent systematic review states that, depending on the de nition used, the prevalence of restraint use in older persons in home care ranges from 5% to 24.7% (3). Until recently, no consistent de nition of physical restraints could be found in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…Home care differs from residential care as a result of its particular characteristics like interorganizational structures and team compositions (16). In home care, where professional care providers enter brie y the personal environment of the older person, they only see the patient for a short amount of time and cannot ensure 24-hour coverage and supervision when a person is being restrained (3). Thus, the speci c characteristics of the home care setting make it di cult to translate existing evidence from acute and residential care to the home care setting.…”

Section: Introductionmentioning

confidence: 99%

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Reducing the use of physical restraints in home care - Development and evaluation of a multicomponent program to support the implementation of a guideline

Vandervelde

Scheepmans

Milisen

et al. 2020

Preprint

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Background: A validated evidence-based guideline was developed to reduce physical restraint use in home care. However, the implementation of guidelines in home care is challenging. Therefore, this study aims to systematically develop and evaluate a multicomponent program for the implementation of the guideline for reducing the use of physical restraints in home care.Methods: Intervention Mapping was used to develop a multicomponent program. This method contains six steps. Each step comprises several tasks towards the design, implementation and evaluation of an intervention; which is theory and evidence informed, as well as practical. To ensure that the multicomponent program would support the implementation of the guideline in home care, a feasibility study of eight months was organized in one primary care district in Flanders, Belgium. A concurrent mixed methods design was used to evaluate the multicomponent program consisting of a knowledge test, focus groups and an online survey.Results: The Social Cognitive Theory and the Theory of Planned Behavior are the foundations of the multicomponent program. Based on modeling, active learning, guided practice, belief selection and resistance to social pressure, eight practical applications were developed to operationalize these methods. The key components of the program are: the ambassadors for restraint-free home care (n =15), the tutorials, the physical restraint checklist and the flyer. The results of the feasibility study show the necessity to select uniform terminology and definition for physical restraints, to involve all stakeholders from the beginning of the process, to take time for the implementation process, to select competent ambassadors and to collaborate with other home care providers.Conclusions: The multicomponent program shows promising results. Prior to future use, further research needs to focus on the last two steps of Intervention Mapping (program implementation plan and developing an evaluation plan), to guide implementation on a larger scale and to formally evaluate the effectiveness of the multicomponent program.

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Section: Matrices Of Change Objectivesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reducing the use of physical restraints in home care - Development and evaluation of a multicomponent program to support the implementation of a guideline

Vandervelde

Scheepmans

Milisen

et al. 2020

Preprint

Self Cite

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show abstract

“…Restrictive practices, attitudes, behaviours and consequent interventions such as restraint, remains an emotive subject internationally and across all fields of nursing. It is especially highlighted within mental health nursing, learning disabilities and elderly care settings (Bowers 2007, Gulpers et al 2012, Griffiths 2013, Scheepmans et al 2017. The problem with restrictive practices in healthcare in general, and in acute care settings in particular, is not new but it has persisted over the years despite attempts to contain it.…”

Section: Piimentioning

confidence: 99%

“…Examples of physical restraint vary in the international literature, with some being more commonly found in certain countries and practice domains. Bed-rails, fixed tables and wrist restraints are evident in elderly care in Germany, Holland and France (Kruger et al 2013, Scheepmans et al 2017. Physical, chemical, and in some cases mechanical restraint feature in mental health nursing and learning disabilities in England (NICE 2015), while the use of mittens and chemical restraint is not unusual in intensive care units internationally (Kruger et al 2013).…”

Section: Inadequate Research Attentionmentioning

confidence: 99%