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Reducing and managing restraints in long-term-care facilities.
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1992 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 40, no 4, 381-5 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate a management system designed to improve staff adherence to a federal regulation that stated restrained residents should be released, exercised, and repositioned every 2 hours. DESIGN: A delayed intervention, controlled, cross-over design with three phases. During phase one, baseline, the length of intervals that residents remained in restraints was monitored. The intervention was implemented at site A in Phase two while site B remained in baseline. During Phase three, the intervention was replicated at site B. SETTING: Two long-term care proprietary nursing facilities. PATIENTS: Sixty-three physically restrained residents in the two facilities. INTERVENTION: The intervention was a system of restraint release using colored pads corresponding to specific hours. The management rule was that the resident should be on a different colored pad every 2 hours. Staff had to lift residents to place the pad, and the colors made the system easy for supervisors to check. MAIN OUTCOME MEASURES: Checks by research personnel by black light and invisible ink, to detect movement of the knot tying the restraints. RESULTS: During the baseline phase, the majority of residents at both sites were inappropriately restrained longer than 2 hours (site A: 54.1%; site B: 60.1%). The percentage of residents restrained over 2 hours was significantly reduced during the intervention phase to 13.9% (site A) and 19.4% (site B). Three weeks after the end of the intervention, inappropriate use of restraints remained low, 14.2%, but rose to 47.7% after another 3 weeks. CONCLUSION: The management system is an effective way to increase the consistency with which nursing-home staff release and reposition restrained residents.

Place, publisher, year, edition, pages
1992. Vol. 40, no 4, 381-5 p.
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-115PubMedID: 1556366OAI: oai:DiVA.org:esh-115DiVA: diva2:319152
Available from: 2010-05-14 Created: 2010-05-14 Last updated: 2011-04-06Bibliographically approved

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