Organizational factors associated with less use of restraints in older adults with dementia in acute care hospitals: A scoping review.

Autor: Makino M; Gerontological Nursing, Department of Clinical Nursing, Hamamatsu University School of Medicine, Hamamatsu, Japan., Kato M; Division of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, japan., Naruse S; School of Nursing, University of Shizuoka, Shizuoka, Japan., Yoshie Y; Department of Nursing, Faculty of Health Science, Fukui Health Science University, Fukui, Japan., Eda K; Doctoral Course, Graduate School of Medical Sciences, Kanazawa University Graduate School, Kanazawa, Japan.
Jazyk: angličtina
Zdroj: Japan journal of nursing science : JJNS [Jpn J Nurs Sci] 2024 Oct; Vol. 21 (4), pp. e12620. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1111/jjns.12620
Abstrakt: Objective: Dementia affects more than 55 million people worldwide. Use of restraints for hospitalized older adults with dementia is a social issue that should be addressed systematically and should not depend on the characteristics of nurses. This study reviewed the literature on organizational factors associated with reducing use of restraints in older adults with dementia admitted to acute care hospitals.
Methods: A scoping review was performed. Three databases were searched for papers that met our eligibility criteria. Factors related to restraint reduction were extracted, and results were deduced. Through inductive analysis, subthemes were categorized according to similarities and differences, which were then integrated into broader themes.
Results: Sixteen studies were eligible for inclusion. The prevalence of restraints ranged from 5.1% to 80.0% depending on how the meaning of restraint was interpreted. The most common indications for restraints were history of falls and fall risk. Interdisciplinary screening for restraints was associated with reduced prevalence of restraints, with a 0.18-fold (confidence interval [CI]: 0.12-0.24) reduction through use of a restraint decision flowchart and a 0.76-fold (CI: 0.63-0.92) reduction through consultation with a psychiatrist. Interdisciplinary members included nurses, physicians, clinical psychologists, pharmacists, respiratory therapists, and therapists.
Conclusions: Research is needed to introduce and develop an interdisciplinary restraint decision-making system and to test its effectiveness. Important factors in implementing alternatives to restraints are the harmful effects of restraints, expertise in dementia, regular education on alternative methods, an inpatient environment that ensures patient safety, and the development of human resources.
(© 2024 The Author(s). Japan Journal of Nursing Science published by John Wiley & Sons Australia, Ltd on behalf of Japan Academy of Nursing Science.)
Databáze: MEDLINE
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