Reducing physical restraints in psycho-geriatric nursing home residents.

Physical restraints are still frequently used in nursing home residents despite growing evidence for the ineffectiveness and negative consequences of these methods. Therefore, reduction of physical restraint use is very important. The aim of the study is to investigate whether an educational intervention has an effect on the use of physical restraints in psycho-geriatric nursing home resident. A cluster randomized trial is applied to 15 psycho-geriatric nursing home wards (n=400 residents with dementia). The wards were assigned at random to either educational intervention (8 wards) or control status (7 wards). At baseline, 1 month, 4 months and 8 months post-intervention, restraint status was observed and residents’ characteristics, like mobility, cognitive status and fall incidence, were determined by using the Minimum Data Set (MDS) version 2.1 and the accident registration form. Organizational characteristics, like workload of nurses and FTE were determined by questionnaires and examination of registration systems of the nursing homes.

It is hypothesized that an educational intervention will lead to a reduction of restraint use in psycho-geriatric nursing home residents.

N/A

The educational intervention consists of an educational programme combined with consultation with a nurse specialist. The educational intervention is designed to comply with the decision-making process concerning restraint use defined in a Dutch guideline for restraint use in care situations and to cause nurses to embrace a philosophy of restraint-free care and be familiar with techniques of individualized care. Nurses in the experimental group attended the educational programme on restraint use. Furthermore, consultation with a nurse specialist was introduced on the experimental wards. There was no educational intervention in the control group and residents received the normal care.