Em. Sullivan-marx et al., Initiation of physical restraint in nursing home residents following restraint reduction efforts, RES NURS H, 22(5), 1999, pp. 369-379
In this pilot study a one group pretest posttest design was employed to ide
ntify resident characteristics and environmental factors associated with in
itiation of physical restraint. Predictors of restraint initiation for olde
r adults were examined using secondary analysis of an existing data set of
nursing home residents who were subjected to a federal mandate and signific
ant restraint reduction efforts. Lower cognitive status (OR = 1.5 [for ever
y 7-point decrease in Mini-Mental State Examination], 95% CI = 1.0, 2.1) an
d a higher ratio of licensed nursing personnel (OR = 3.7, 95% CI = 1.2, 11.
9) were predictive of restraint initiation. Key findings suggest that restr
aint initiation occurs, despite significant restraint reduction efforts, wh
en a nursing home resident is cognitively impaired or when more licensed nu
rsing personnel (predominantly licensed practical nurses) are available for
resident care. Achievement of restraint-free care in nursing homes require
s specific and individualized approaches for residents who are cognitively
impaired, as well as greater attention to staff mix of registered nurses, l
icensed practical nurses, and nursing aides. (C) 1999 John Wiley & Sons. In
c.