title: A cluster-randomized trial of an educational intervention to reduce the use of physical restraints with psychogeriatric nursing home residents.
abstract: OBJECTIVE
  To investigate the effects of an educational intervention on the use of physical restraints with psychogeriatric nursing home residents.
  
  
  METHODS
  Cluster-randomized trial.
  
  
  METHODS
  Fifteen psychogeriatric nursing home wards in the Netherlands.
  
  
  METHODS
  In total, 432 psychogeriatric nursing home residents from 15 psychogeriatric nursing home wards in seven nursing homes were selected for participation; 404 consented, and 371 of these were available at baseline. Two hundred forty-one from 14 wards had complete data and were included in the data analyses.
  
  
  METHODS
  The nursing home wards were assigned at random to educational intervention or control status. The educational intervention consisted of an educational program for nursing staff combined with consultation with a nurse specialist (registered nurse (RN) level).
  
  
  METHODS
  Data were collected at baseline and 1, 4, and 8 months postintervention. At each measurement, the use of physical restraints was measured using observations of blinded, trained observers on four separate occasions over a 24-hour period. Other resident characteristics, such as cognitive status, were determined using the Minimum Data Set.
  
  
  RESULTS
  Logistic and linear regression analyses showed no treatment effect on restraint status, restraint intensity, or multiple restraint use in any of the three postintervention measurements. Furthermore, only small changes occurred in the types of restraints used with residents in the experimental group.
  
  
  CONCLUSIONS
  An educational program for nursing staff combined with consultation with a nurse specialist (RN level) had no effect on the use of physical restraints with psychogeriatric nursing home residents. In addition to restraint education and consultation, new measures to reduce the use of physical restraints with psychogeriatric nursing home residents should be developed.
authors: Health Care and Nursing Science, Maastricht University, Maastricht, The Netherlands.
authors: Anna R
authors: AR
authors: Huizing
authors: Jan P H
authors: JP
authors: Hamers
authors: Math J M
authors: MJ
authors: Gulpers
authors: Martijn P F
authors: MP
authors: Berger
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000193:education*; D006801:Humans; D007318:Inservice Training; D009426:Netherlands; D009730:Nursing Assessment; D009735:Nursing Homes; D009740:Nursing Staff / Q000193:education*; D011568:Psychiatric Nursing / Q000193:education*; D012044:Regression Analysis; D012149:Restraint, Physical / Q000706:statistics & numerical data*