The use of physical restraints in long-term care in Spain: a multi-center cross-sectional study

BMC Geriatrics

Research Article

Eduardo Núñez-González¹  Fernando Calvo-Francés²  Emilio Fariña-López³  Gabriel J. Estévez-Guerra⁴  Manuel Gandoy-Crego⁵  Elizabeth A. Capezuti⁶ 

[1] Clinic Sciences Department, University of Las Palmas de Gran Canaria, Tahiche, Spain;Nursing Department, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain;Nursing Department, University of Las Palmas de Gran Canaria, Tahiche, Spain;Nursing Department, University of Las Palmas de Gran Canaria, Tahiche, Spain;Unidad Docente de Enfermería de Lanzarote. Facultad de Ciencias de la Salud. ULPGC, C/Rafael Alberti 50, 35507, Tahiche, Spain;Nursing Department, University of Santiago de Compostela, Santiago de Compostela, Spain;William Randolph Hearst Foundation Chair in Gerontology, Hunter College of the City University of New York, New York, NY, USA;

关键词: Aged;    Long-term care;    Restraint, physical;   

DOI  :  10.1186/s12877-017-0421-8

 received in 2016-08-16, accepted in 2017-01-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPhysical restraint is a procedure used frequently in long-term care. It is a controversial practice because its use is associated with numerous complications and also affects freedom and individual autonomy. The objective of this study was to examine the use of physical restraint of long-term care residents with the ability to move voluntarily.MethodsWe conducted a cross-sectional observational and correlational multi-center study. Nine centers agreed to participate. Of the 1,200 people present at the time of data collection, those without voluntary movement or in the facility for less than a month were excluded. Thus, the final sample was 920 residents. Data on the use of restraints was collected by direct observation. Information about the age, gender, length of stay, falls, mobility, cognition and functional status of residents was gathered by reviewing clinical records and interviewing nursing staff. A descriptive analysis of the data obtained was conducted. The generalized linear model was used, considering only the principal effects of each variable and using the logit link function. The model has been adjusted for clusters and for other possibly confounding factors. For all analyses, a confidence interval (CI) of 95% was estimated.ResultsThe prevalence of residents with at least one physical restraint was 84.9% (95% CI: 81.7–88.1), with variability between centers of 70.3 to 96.6% (p-value Kruskal Wallis test <0.001). Full-enclosure side rails were most often used (84.5; 95% CI: 81.1–87.9), but other types of restraints were also used frequently. Multivariate analysis showed that the degree of functional impairment increased the probability of the use of restraint. A significant association was also found between restraint use and the impaired cognitive status of residents.ConclusionsThe prevalence was higher than in studies from other countries. The results emphasize the need to improve the training of nursing staff in the care of residents with impairments in functional and cognitive status. The use of alternative devices and nurse consultants need to be evaluated, and the introduction of specific laws considered.

【 授权许可】

CC BY   
© The Author(s). 2017