Patient choice: an influencing factor on policy-related research to decrease bedrail use as physical restraint.
BACKGROUND
This paper shows patients' enactment of choice in mixed methods, multidisciplinary study on the use of bedrails as restraints.


METHODS
Under the pressure of the implementation of impending legislation, patients from a Canadian elderly care rehabilitation unit were recruited to be part of this study and assigned to either a study or control group. Study group patients were exposed to a new facility policy on restraints in which bedrails were not to be used on a patient's bed except under specified conditions. Patients in the control group continued to have bedrails on a routine basis according to the facility's old policy. Following group assignments, patients could choose to crossover to either the control or study group based on their opinions about bedrails.


RESULTS
After patients crossed over into either the study or control group, findings for the new groups differed significantly. Participants in the rails-up group had lower admission Functional Independence Measure scores (p = .001) and higher admission Cumulative Illness Rating scores (p = .000) compared to those in the rails-down group.


CONCLUSIONS
Patients have specific concerns related to the use of bedrails that might affect implementing bedrail minimization policies. Additionally, the authors conclude that patients' input into research design may increase patients' support of the protocol and help maintain study integrity.
Ralphs-Thibodeau
Sylvia
S
University of Ottawa and Elisabeth Bruyère Research Institute, Ottawa, Ontario, Canada. sralphsthibodeau@gmail.com
Knoefel
Frank
F
Benjamin
Kathleen
K
Leclerc
Anne
A
Pisterman
Susan
S
Sohmer
Jane
J
Scrim
Carmel
C
D000368:Aged; D000369:Aged, 80 and over; D001513:Beds; D002170:Canada; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017060:Patient Satisfaction; D012047:Rehabilitation Centers; D012149:Restraint, Physical