A cluster-randomized trial of an educational intervention to reduce the use of physical restraints with psychogeriatric nursing home residents.
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.
Huizing
Anna R
AR
Health Care and Nursing Science, Maastricht University, Maastricht, The Netherlands.
Hamers
Jan P H
JP
Gulpers
Math J M
MJ
Berger
Martijn P F
MP
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*