Table of Content
- Physical Restraint Reduction
- Restraint reduction in a nursing home and its impact on employee attitudes
- A clinical trial to reduce restraints in nursing homes
- Description of an advanced practice nursing consultative model to reduce restrictive siderail use in nursing homes.
- Effect evaluation
- Staffing levels and the use of physical restraints in nursing homes: a multicenter study.
The proposed changes in legislation provide an opportunity to develop a multi-component intervention tailored to the Dutch nursing home environment that will assist facilities in meeting this new requirement. The use of physical restraints still is common practice in the nursing home care. Since physical restraints have been shown to be an ineffective and sometimes even hazardous measure, interventions are needed to reduce their usage.
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Physical Restraint Reduction
Data regarding the process evaluation will be gathered regarding the eight month period between baseline and T3. First, to investigate the opinion of nursing home staff, the nursing home management and the residents' relatives about EXBELT and the effectiveness of alternative interventions, structured interviews will be used. Second, intervention fidelity, including the dose delivered, and dose received , will be obtained by conducting interviews with nursing home staff, nursing home management, educators and consultants. In addition, checklists and observation forms will be used to document fidelity of the intervention across nursing home units assigned to the intervention group. Finally, to examine the influence of the EXBELT on attitudes and opinions regarding restraint use, we will measure attitudes of nursing home staff using the MAQ at baseline, after the education program and at the end of the project. No change occurred in the number of staff hours per resident, and no increase was seen in psychoactive drug use in the two nursing homes that underwent intervention.
The recent expansion of the pilot to other wards in the same nursing home has shown similar results. However, this home does not represent a typical Dutch facility since it is considered as 'best practice' regarding restraint reduction initiatives and research. Thus, further testing of the EXBELT intervention is needed on wards in other nursing homes prior to widespread dissemination. A cluster-randomized trial of an educational intervention to reduce the use of physical restraints with psychogeriatric nursing home residents.
Restraint reduction in a nursing home and its impact on employee attitudes
The baseline rate of falls was lowest in the control nursing home but, after the interventions, this nursing home had a higher rate of falls than the other two nursing homes. A new multi-component intervention comprising an educational intervention for nursing home staff in combination with a policy change, availability of a nurse specialist and nursing home manager as consultants, and availability of alternative interventions is developed. To test the effects of a multicomponent intervention program to reduce the use of belt restraints in psychogeriatric nursing homes. Process evaluation of a multicomponent intervention program to reduce belt restraints in nursing homes.
Data will be collected at baseline , and four and eight months after baseline. Predictors of continued physical restraint use in nursing home residents following restraint reduction efforts. Attitudes of relatives of nursing home residents toward physical restraints.
A clinical trial to reduce restraints in nursing homes
Interventions for preventing and reducing the use of physical restraints of older people in general hospital settings. Comparability between the intervention and control groups will be assessed at baseline to check for differences between the two groups on socio-demographic characteristics . Outcomes at T2 and T3 will be compared between the intervention and control groups by both univariate and multivariate techniques.
All authors critically reviewed the manuscript, read and approved the final manuscript. Before sharing sensitive information, make sure you’re on an official government site. Interventions for preventing falls in older people in care facilities and hospitals. The objective was to investigate restraint use and its associations with neuropsychiatric symptoms and personal characteristics in residential care. Before sharing sensitive information, make sure you’re on a federal government site. Forty registered nurse and geriatric care assistant informants participated in the first round of interviews and 16 of them participated in second confirmatory interviews.
Trial registration
All interviews were conducted on site, one-on-one and face-to-face, using semi-structured interview protocols. Qualitative descriptive method was used and qualitative content analysis was employed. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. It is suggested that an APN consultation model can effectively be implemented through comprehensive, individualized assessment without incurring substantial costs to the nursing home. Use of restraint amongst institutionalised elderly with dementia and problem behaviour not only remains widespread, but also appears to be accepted as inevitable. One specific module focused on strategies for changing attitudes such as shifting perspectives .
Overlap of nursing home staff between the intervention and control wards was averted. In addition, based on the geographical location of the participating wards, wards from each of the four nursing associations that were situated closely together were allocated to the same group. The wards allocated to the control group will receive care as usual, while the wards allocated to the intervention group will receive the EXBELT program. After one month follow up, no belt was used, but after three and nine months follow up 1 belt was used. This reduction in belt use did not result in either an increase in the number of falls and related injuries or the use of other restrictive measures such as chairs with a locked tray table or psychoactive medication. Belts were replaced with, resident-centered interventions, such as movement and balance training, lower beds, hip protectors, extra supervision and monitoring devices .
The effects of a restraint minimization education program on staff knowledge and attitudes and use of physical restraints are evaluated. A quasi-experimental study is presented to investigate the effects of EXBELT on the use of belts on wards in psychogeriatric nursing homes. The study will be conducted in 26 wards in 13 psychogeriatric nursing homes.
The findings of this study provide a valuable basis for developing restraint reduction education programs. This paper presents the design of a quasi-experimental study, which aims to explore the effect and feasibility of an intervention program that aims to reduce the use of belts in Dutch psychogeriatric nursing homes. Some methodological and practical drawbacks, concerning the current design, exist. However, under the current circumstances it is the most feasible method the assess data on the effectiveness of the intervention program.
Furthermore, changing attitudes will become an important addition to the educational part of EXBELT. To participate, the prevalence of belt use on psychogeriatric nursing home wards had to be at least 10%. Wards are excluded if the unit is dedicated to residents with Korsakoff's, if far-reaching reorganizations and/or constructional renovations will be implemented, and if participating in other studies and/or projects aimed at the reduction of restrain use. The total study sample comprises four nursing home associations, 13 nursing homes with a total of 26 psychogeriatric wards. Assignment to either to intervention or control groups was carried out by the research team. Since no randomization took place, allocation was based on avoidance of contamination bias.
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