Use of physical restraints in acute hospitals in Germany: A multi-centre cross-sectional study

Krüger, C; Mayer, Herbert; Haastert, Burkhard; Meyer, Gabriele

doi:10.1016/j.ijnurstu.2013.05.005

Cited by 99 publications

(98 citation statements)

References 27 publications

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“…In relation to the comparison of the three PRUQ scale scores, and as has been found in other studies (Huang et al., ; Krüger et al., ; Minnick et al., ; Möhler & Meyer, ), in general, nurses are strongly committed to ensuring a safe environment for older patients and preventing interference with treatments, regardless of the fact that they are restricting patient mobility. Possibly, patients are seen as vulnerable and fragile, a perception that will encourage a pro‐restraint attitude (Estévez‐Guerra et al., ).…”

Section: Discussionmentioning

confidence: 71%

Validity and measurement invariance of the Physical Restraint Use Questionnaire (PRUQ) in nursing staff

Penelo

Estévez-Guerra

Fariña-López

2018

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 71%

Validity and measurement invariance of the Physical Restraint Use Questionnaire (PRUQ) in nursing staff

Penelo

Estévez-Guerra

Fariña-López

2018

Journal of Clinical Nursing

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“…We found that PR use in Canadian ICUs is frequent despite provincial legislation and national accreditation standards requiring restraint minimization to maintain patient safety and provide quality health care [16,31]. Internationally, use of PR in ICUs is highly variable with recent survey data and observational studies reporting prevalence rates between 15% and 100% [9,12,28,32-34]. The highest prevalence rates (for example, 90% or 100%) were found in single ICU settings [9,32].…”

Section: Discussionmentioning

confidence: 99%

Predictors of physical restraint use in Canadian intensive care units

et al. 2014

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IntroductionPhysical restraint (PR) use in the intensive care unit (ICU) has been associated with higher rates of self-extubation and prolonged ICU length of stay. Our objectives were to describe patterns and predictors of PR use.MethodsWe conducted a secondary analysis of a prospective observational study of analgosedation, antipsychotic, neuromuscular blocker, and PR practices in 51 Canadian ICUs. Data were collected prospectively for all mechanically ventilated adults admitted during a two-week period. We tested for patient, treatment, and hospital characteristics that were associated with PR use and number of days of use, using logistic and Poisson regression respectively.ResultsPR was used on 374 out of 711 (53%) patients, for a mean number of 4.1 (standard deviation (SD) 4.0) days. Treatment characteristics associated with PR were higher daily benzodiazepine dose (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.00 to 1.11), higher daily opioid dose (OR 1.04, 95% CI 1.01 to 1.06), antipsychotic drugs (OR 3.09, 95% CI 1.74 to 5.48), agitation (Sedation-Agitation Scale (SAS) >4) (OR 3.73, 95% CI 1.50 to 9.29), and sedation administration method (continuous and bolus versus bolus only) (OR 3.09, 95% CI 1.74 to 5.48). Hospital characteristics associated with PR indicated patients were less likely to be restrained in ICUs from university-affiliated hospitals (OR 0.32, 95% CI 0.17 to 0.61). Mainly treatment characteristics were associated with more days of PR, including: higher daily benzodiazepine dose (incidence rate ratio (IRR) 1.07, 95% CI 1.01 to 1.13), daily sedation interruption (IRR 3.44, 95% CI 1.48 to 8.10), antipsychotic drugs (IRR 15.67, 95% CI 6.62 to 37.12), SAS <3 (IRR 2.62, 95% CI 1.08 to 6.35), and any adverse event including accidental device removal (IRR 8.27, 95% CI 2.07 to 33.08). Patient characteristics (age, gender, Acute Physiology and Chronic Health Evaluation II score, admission category, prior substance abuse, prior psychotropic medication, pre-existing psychiatric condition or dementia) were not associated with PR use or number of days used.ConclusionsPR was used in half of the patients in these 51 ICUs. Treatment characteristics predominantly predicted PR use, as opposed to patient or hospital/ICU characteristics. Use of sedative, analgesic, and antipsychotic drugs, agitation, heavy sedation, and occurrence of an adverse event predicted PR use or number of days used.

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“…Seclusion and restraint rates, duration and methods used in inpatient mental health care vary widely across countries and between units in the same hospital or area (Beghi, Peroni, Gabola, Rossetti, & Cornaggia, 2013;Knott, Pleban, Taylor, & Castle, 2007;Tekkas & Bilgin, 2010). These variations can be accounted for by characteristics of the settings and case mix, as well as different definitions and data collection techniques (Kruger, Mayer, Haastert, & Meyer, 2013). For the purposes of this study we have used the term 'containment' to refer to restriction of movement through physical (hands-on immobilisation), mechanical (the use of devices such as lap belts or jackets) or environmental (confinement of the patient at any time of the day or night alone in a room or area from which free exit is prevented; seclusion) means.…”

Section: Introductionmentioning

confidence: 99%

Seclusion and restraint use in adult inpatient mental health care: An Australian perspective

Oster

Gerace

Thomson³

et al. 2016

Collegian

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Use of physical restraints in acute hospitals in Germany: A multi-centre cross-sectional study

Cited by 99 publications

References 27 publications

Validity and measurement invariance of the Physical Restraint Use Questionnaire (PRUQ) in nursing staff

Validity and measurement invariance of the Physical Restraint Use Questionnaire (PRUQ) in nursing staff

Predictors of physical restraint use in Canadian intensive care units

Seclusion and restraint use in adult inpatient mental health care: An Australian perspective

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