Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-vbn2q Total loading time: 0.388 Render date: 2021-08-03T11:04:44.305Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant*

Published online by Cambridge University Press:  31 March 2010

Pierre J. Durand
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec Département de médecine sociale et préventive de L'Université Laval, Québec Département de médecine de L'Université Laval, Québec
Jean-Paul Ouellet
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec
Line Beauchesne
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec
André Tourigny
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec
René Verreault
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec Département de médecine sociale et préventive de L'Université Laval, Québec Département de médecine de L'Université Laval, Québec
Louise Dicaire
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec Hôpital Jeffrey Hale
Louise Lévesque
Affiliation:
Centre Hospitalier Côte des Neiges, Montréal
Sylvie Lauzon
Affiliation:
Faculté des sciences infirmières de L'Université de Montréal, Montréal
Robin Gagnon
Affiliation:
Direction des soins infirmiers, Centre hospitalier régional de Lanaudière, Saint-Charles Borromée
Louis Rochette
Affiliation:
Unité de recherche en gériatrie de L'Université Laval, Centre d'hébergement Saint-Augustin du Centre Hospitalier Affilié universitaire de Québec, Beauport, Québec
Corresponding

Abstract

This study aimed at (a) developing a restraint reduction program, (b) describing its implementation in long-term care units, and (c) examining its effects on care staff's perceptions of and knowledge about the use of restraints. The program was composed of three parts: consciousness-raising meetings, staff education, and clinical follow-up. The study was a randomized, controlled clinical trial with eight intervention care units (five nursing homes) and 11 controls (five additional nursing homes). Care staff was surveyed at two time intervals over a 7-month period (pre- and post-test intervention; intervention care units: N = 171 [T0] and N = 158 [T1]; controls: N = 181 [T0] and N = 166 [T1]). The implementation of the program was successful and results showed significant changes in care staff perceptions of and knowledge about the use of restraints.

Résumé

Les buts de cette étude étaient de développer un programme d'intervention visant à réduire L'utilisation des contentions physiques, de décrire son implantation dans des unités de soins de longue durée et d'évaluer ses effets sur le personnel soignant en termes de connaissances et de perceptions quant à L'utilisation de ces contentions. Le programme comportait trois composantes: sensibilisation, formation et suivi clinique. Le devis méthodologique est celui d'un essai clinique randomisé à mesures répétées. Le questionnaire auto-administré a été rempli avant (T0) et sept mois (T1) après le début du programme par le personnel soignant de huit unités de soins expérimentales réparties dans cinq centres (N = 171 [T0]) et N = 158 [T1]) et de onze unités témoins provenant de cinq autres centres (N = 181 [T0] et N = 166 [T1]). Le programme a été implanté avec succès et s'est avéré efficace pour modifier les connaissances et les perceptions du personnel soignant en regard de L'utilisation des contentions physiques.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Nous exprimons toute notre gratitude aux infirmières de recherche, mesdames Maryse Bernard, Thérèse Harrisson et Diane Richard qui ont recueilli les questionnaires dans les unités de soins. Nous tenons aussi à remercier la direction et le personnel des centres d'hébergement et de soins de longue durée (CHSLD) qui ont accepté de participer au projet de recherche.

References

AHQ. (1996). L'utilisation de la contention physique chez les personnes âgées: une pratique à réviser. Bibliothèque Nationale du Québec, 158.Google Scholar
Ashmore, M. (1988). Reducing physical restraints-ethical and legal implications. Canadian Health Care Management Supplement (Methuen Dispatch) (December).Google Scholar
Bernard, S. (1999). Étude descriptive de L'utilisation des contentions physiques auprès des personnes âgées hébergées en centres d'hébergement et de soins de longue durée. Mémoire de maîtrise non-publiée, Université Laval, Québec.Google Scholar
Bradley, L., Siddique, C. M., & Dufton, B. (1995). Reducing the use of physical restraints in long-term care facilities. Journal of Gerontological Nnursing, 21, 2134.CrossRefGoogle Scholar
Bryant, H., & Fernald, L. (1997). Nursing knowledge and use of restraint alternatives: Acute and chronic care. Geriatric Nursing, 18(2), 5760.CrossRefGoogle Scholar
Burton, L. C., German, P. S., Rovner, B. W., Brant, L. J., & Clark, R. D. (1992). Mental illness and the use of restraints in nursing homes [see comments]. Gerontologist, 32(2), 164170.CrossRefGoogle Scholar
Cape, R. (1983). Freedom from restraint. Gerontol, 23, 217.Google Scholar
Charpentier, M. (1999). L'hébergement des personnes âgées à L'aube de L'an 2000: tendances et enjeux cliniques. Dans Edisem (Éd.), Autonomie et vieillissement, actes du congrès scientifique. Sherbrooke.Google Scholar
Chien, W. T. (2000). Use of physical restraints on hospitalized psychogeriatric patients. Journal of Psychosocial Nursing and Mental Health Services, 38(2), 1322.Google Scholar
Cohen, C., Neufeld, R., Dunbar, J., Pflug, L., & Breuer, B. (1996). Old problem, different approach: Alternatives to physical restraints. Journal of Gerontological Nursing, 22(2), 2329.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., & Billig, N. (1986). Agitated behaviors in the elderly. American Geriatrics Society, 34, 711721.CrossRefGoogle ScholarPubMed
Collerette, P., et Delisle, G. (1982). Le changement planifié. Une approche pour intervenir dans les systèmes organisationnels. Montréal.Google Scholar
Cooper, C. J. (2000). Reducing the use of physical restraints in nursing homes: Regulatory harassment or good medicine? Postgraduate Medicine, 107(2), 15.CrossRefGoogle ScholarPubMed
Cruz, V., Abdul-Hamid, M., & Heater, B. (1997). Researsh-based practice: Reducing restraints in an acute care setting - phase 1. Journal of Gerontological Nursing, 23(2), 3140.CrossRefGoogle Scholar
Durand, P. J, Ouellet, J.P., Beauchesne, L., Tourigny, A., Verreault, R., Dicaire, L., Lévesque, L., Lauzon, S., Gagnon, R., et Rochette, L. (2000). Modifications de pratiques de soins en milieu d'hébergement: impact d'un programme d'intervention visant à réduire L'utilisation des contentions physiques. Québec: Unité de recherche en gériatrie de L'Université Laval.Google Scholar
Durand, P. J. (1993). Concordance entre la déclaration et L'observation de la contention physique en soins de longue durée. Mémoire de maîtrise non-publiée, Université Laval, Québec.Google Scholar
Ejaz, F. K., Folmar, S. J., Kaufmann, M., Rose, M. S., & Goldman, B. (1994). Restraint reduction: Can it be achieved? The Gerontologist, 34(5), 694699.Google ScholarPubMed
Ejaz, F. K., Rose, M. S., & Jones, J. A. (1996). Changes in attitudes toward restraints among nursing home staff and residents' families following restraint reduction. Journal of Applied Gerontology, 15(4), 433449.CrossRefGoogle Scholar
Evans, L. K., & Strumpf, N. E. (1989). Tying down the elderly: A review of the literature on physical restraint. JAGS, 36, 6574.CrossRefGoogle Scholar
Evans, L. K., Strumpf, N. E., AllenTaylor, S. L., Capezuti, E., Maislin, G., & Jacobsen, B. (1997). A clinical trial to reduce restraints in nursing homes. Journal of the American Geriatrics Society, 45(6), 675681.CrossRefGoogle ScholarPubMed
Frank, C., Hodgetts, G., & Puxty, J. (1996). Safety and efficacy of physical restraint for the elderly. Review of the evidence. Canadian Family Physician, 42, 24022409.Google Scholar
Frengley, J. D., & Mion, L. C. (1986). Incidence of physical restraints on acute general medical wards. American Geriatrics Society, 34, 565568.CrossRefGoogle ScholarPubMed
Gouvernement du Québec (1987). Décès par contention. Rapport d'enquête du coroner Anne-Marie David. Montréal: Bureau du coroner en chef.Google Scholar
Gutheil, T., & Tardiff, K. (1984). Indication and contraindication for seclusion and restraint. Washington DC: APA Press.Google Scholar
Hagan-Hennessy, C., McNeely, E. A., Whittington, F. J., Strasser, D. C., & Archea, C. K. (1997). Perceptions of physical restraint use and barriers to restraint reduction in a long-term care facility. Journal of Aging Studies, 11(1), 4962.CrossRefGoogle Scholar
Hantikainen, V. (1998). Physical restraint: A descriptive study in Swiss nursing homes. Nursing Ethics, 5(4), 330346.CrossRefGoogle ScholarPubMed
Hardin, S. B., Magee, R., Stratmann, D., Vinson, M., Owen, M., & Hyatt, E. (1994). Extended care and nursing home staff attitudes toward restraints. Journal of Gerontological Nursing, 20(3), 2331.CrossRefGoogle ScholarPubMed
Hill, J., & Schirm, V. (1996). Attitudes of nursing staff toward restraint use in long-term care. Journal of Applied Gerontology, 15(3), 314324.CrossRefGoogle Scholar
Janelli, L. M., Kanski, G. W., Scherer, Y. K., & Neary, M. A. (1992). Physical restraints: Practice, attitudes and knowledge among nursing staff. The Journal of Long-Term Care Administration, Summer, 2225.Google ScholarPubMed
Karlsson, S., Bucht, G., Eriksson, S., & Sandman, P. O. (1996). Physical restraints in geriatric care in Sweden: Prevalence and patient characteristics. JAGS, 44, 13481354.CrossRefGoogle Scholar
Karlsson, S., Bucht, G., & Sandman, P. (1998). Physical restraints in geriatric care: Knowledge, attitudes and use. Scandinavian Journal of Caring Sciences, 12(1), 4856.Google Scholar
Katz, F., Weber, F., & Dodge, P. (1981). Patient restraint and safety vests: Minimizing the hazards. Dimensions Health Serv, 58, 10.Google ScholarPubMed
Koepsell, T. D., Wagner, E. H., Cheadle, A. C., Patrick, D. L., Martin, D. C., Diehr, P. H., & Perrin, E. B. (1992). Selected methodological issues in evaluating community-based health promotion and disease prevention programs. Annual Review of Public Health, 13, 3157.CrossRefGoogle ScholarPubMed
Lee, D. T. F., Chan, M. C., Tam, E. P. Y., & Yeung, W. S. K. (1999). Use of physical restraints on elderly patients: An exploratory study of the perceptions of nurses in Hong Kong. Journal of Advanced Nursing, 29(1), 153159.CrossRefGoogle ScholarPubMed
Levine, J. M., Marchello, V., & Totolos, E. (1995). Progress toward a restraint-free environment in a large academic nursing facility. Journal of the American Geriatrics Society, 43(8), 914918.Google Scholar
Lewin, L. (1951). Field theory in social science. New York.Google Scholar
Liukkonen, A., & Laitinen, P. (1994). Reasons for uses of physical restraint and alternatives to them in geriatric nursing: A questionnaire study among nursing staff. Journal of Advance Nursing, 19, 10821087.CrossRefGoogle ScholarPubMed
Ljunggren, G., Phillips, C. D., & Sgadari, A. (1997). Comparisons of restraint use in nursing homes in eight countries. Age Aging, 26 Suppl 2, 4347.CrossRefGoogle Scholar
Macpherson, D. S., Lofgren, R. P., Granieri, R., & Myllenbeck, S. (1990). Deciding to restrain medical patients. JAGS, 38, 516520.CrossRefGoogle ScholarPubMed
Magee, R., Hyatt, E. C., Hardin, S. B., Stratmann, D., Vinson, M. H., & Owen, M. (1993). Use of restraints in extended care and nursing homes. Journal of Gerontological Nursing, 19(4), 3139.CrossRefGoogle ScholarPubMed
Marangos-Frost, S., & Wells, D. (2000). Psychiatric nurses' thoughts and feelings about restraint use: A decision dilemma. Journal of Advanced Nursing, 31(2), 362369.CrossRefGoogle ScholarPubMed
Marks, W. (1992). Physical restraints in the practice of medicine. Current concepts. Arch Inter Med, 152, 22032206.CrossRefGoogle ScholarPubMed
Matthiesen, V., Lamb, K. V., McCann, J., Hollinger-Smith, L., & Walton, J. C. (1996). Hospital nurses' views about physical restraint use with older patients. Journal of Gerontological Nursing, 22(6), 816.CrossRefGoogle Scholar
McHutchion, E., & Moise, J. (1989). Releasing restraints a nursing dilemma. Journal of Gerontological Nursing, 15, 1621.CrossRefGoogle Scholar
Middleton, H., Keene, R. G., Johnson, C., Elkins, A. D., & Lee, A. E. (1999). Physical and pharmacologic restraints in long-term care facilities. Journal of Gerontological Nursing, 25(7), 2633.CrossRefGoogle Scholar
Miller, M. (1975). Iatrogenic and nursigenic effects of prolonged immobilization of the ill aged. JAGS, 397398.Google Scholar
Ministère de la santé et des services sociaux (1999). Évolution des places internes du réseau en hébergement et soins de longues durée selon la région de 1991 à 1998. Gouvernement du Québec.Google Scholar
Mion, L., Frengley, J., & Adams, M. (1986). Nursing patients 75 years and older. Nursing Management, 17, 24.Google ScholarPubMed
Mion, L. C., Frengley, J. D., Jakovcic, C. A., & Marino, J. A. (1989). A further exploration of the use of physical restraints in hospitalized patients. American Geriatrics Society, 37, 949956.CrossRefGoogle Scholar
Mitchell-Pederson, L., Edmund, L., & Fingerote, E. (1985). Let's untie the elderly. OAHA Quartely, 21, 10.Google Scholar
Moretz, C., Dommel, A., & Deluca, K. (1995). Untied: A safe alternative to restraints. Medsurgical Nursing, 4(2), 128132.Google ScholarPubMed
Murray, D. (1998). Design and analysis of group-randomized trials (Vol. 27). New York: Oxford University Press.Google ScholarPubMed
Neary, A. M., Kanski, G., Janelli, L., Scherer, Y., & North, N. (1991). Restraints as nurse's aides see them. Geriatric Nursing, July/August, 191192.CrossRefGoogle Scholar
Neufeld, R. R., Libow, L. S., Foley, W., & White, H. (1995). Can physically restrained nursing-home residents be untied safely? Intervention and evaluation design. Journal of the American Geriatrics Society, 43, 12641268.CrossRefGoogle ScholarPubMed
O'keeffe, S., Jack, C., & Lye, M. (1996). Use of restraints and bedrails in a British Hospital. JAGS, 44, 10861088.CrossRefGoogle Scholar
Palmer, L., Abrams, F., Carter, D., & Schluter, W. W. (1999). Reducing inappropriate restraint use in Colorado's long-term care facilities. Journal on Quality Improvement, 25(2), 7894.CrossRefGoogle ScholarPubMed
Phillips, C., Hawes, C., Mor, V., Fries, B., Morris, J., & Nennstiel, M. (1996). Facility and area variation affecting the use of physical restraints in nursing homes. Medical Care, 34(11), 11491162.CrossRefGoogle Scholar
Powell, C., Mitchell-Pedersen, L., Fingerote, E., & Edmund, L. (1989). Freedom from restraint: Consequences of reducing physical restraints in the management of the elderly. Canadian Medical Association, 141, 561564.Google Scholar
Quinn, C. A. (1993). Nurses' perceptions about physical restraints. Western Journal of Nursing Research, 15(2), 148162.CrossRefGoogle Scholar
Restrained in Canada-Free in Britain (Editorial) (1980). Health Care, 22, 22.Google ScholarPubMed
Retsas, A. P. (1997). Use of physical restraints in South Australia's nursing homes. Australian Journal on Aging, 16(4), 169173.CrossRefGoogle Scholar
Retsas, A. P., & Crabbe, H. (1998). Use of physical restraints in nursing homes in New South Wales, Australia. International Journal of Nursing Studies, 35(3), 177183.CrossRefGoogle ScholarPubMed
Robbins, L. J., Boyko, E., Lane, J., Cooper, D., & Jahnigen, D. W. (1987). Binding the elderly: A prospective study of the use of mechanical restraints in an acute care hospital. American Geriatrics Society, 35, 290296.CrossRefGoogle Scholar
Roberge, R., et Beauséjour, R. (1988). L'usage des contentions en milieu d'hébergement pour les personnes âgées. Canadian Journal on Aging, 7, 372376.CrossRefGoogle Scholar
Rubenstein, H., Miller, F., & Postel, S. (1984). Standards of medical care based on consensus rather than evidence: The case of routine bedrail use for the elderly. Law Medical Health Care, 11, 271.Google ScholarPubMed
Schott-Baer, D., Lusis, S., & Beauregard, K. (1995). Use of restraints changes in nurses' attitudes. Journal of Gerontological Nursing, 21(2), 3944.CrossRefGoogle ScholarPubMed
Scott, T., & Gross, J. (1989). Brachial plexus injury due to vest restraints (letter). New England Journal of Medecine, 320, 598.Google Scholar
Stratmann, D., Vinson, M. H., Magee, R., & Hardin, S. B. (1997). The effects of research on clinical practice: The use of restraints. Applied Nursing Research, 10(1), 3943.CrossRefGoogle Scholar
Strumpf, N. E., & Evans, L. K. (1988). Physical restraint of the hospitalized elderly: Perceptions of patients and nurses. Nurs Res, 37, 132137.CrossRefGoogle ScholarPubMed
Sundel, M., Garret, R., & Horn, R. D. (1994). Restraint reduction in a nursing home and its impact on employee attitudes. Journal of the American Geriatrics Society, 42(4), 381387.CrossRefGoogle Scholar
Tadsen, J., & Brandt, R. (1973). Rules for restraints: Hygiene and humanity. Modern Nursing Home, 30, 57.Google Scholar
Terpstra, T. L., Terpstra, T. L., & Doren, E. V. (1998). Reducing restraints: Where to start. The Journal of Continuing Education in Nursing, 29(1), 1016.Google Scholar
Tinetti, M. E. (1987). Factors associated with serious injury during falls by ambulatory nursing home residents. American Geriatrics Society, 35, 644648.CrossRefGoogle Scholar
Tinetti, M. E., Liu, W. L., & Ginter, S. F. (1992). Mechanical restraint use and fall-related injuries among residents of skilled nursing facilities. Annals of Internal Medicine, 116, 369374.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Liu, W. L., Marottoli, R. A., & Ginter, S. F. (1991). Mechanical restraint use among residents of skilled nursing facilities: Prevalence, patterns, and predictors. Journal of the American Medical Association, 265, 468471.CrossRefGoogle Scholar
Unité de recherche en gériatrie de L'Université Laval (1997). Caractéristiques des résidants, du personnel, de L'utilisation des contentions physiques et de L'environnement de travail dans les unités de soins de longue durée - Rapport aux établissements. Québec: Centre d'hébergement Saint-Augustin.Google Scholar
Walshe, A., & Rosen, H. (1979). A study of patient falls from bed. Journal of Nursing Administration, 9, 3135.CrossRefGoogle Scholar
Warshaw, G., Moore, J., & Friedman, J. (1982). Functional disability in the hospitalized elderly. JAMA, 248, 847.CrossRefGoogle ScholarPubMed
Werner, P., Cohen-Mansfield, J., Korokay, V., & Braun, J. (1994). The impact of a restraint-reduction program on nursing home residents. Geriatric Nursing, 15(3), 142146.CrossRefGoogle Scholar
Wieman, H., & Obear, M. (1986). Falls and restraint use in a skilled nursing facility. JAGS, 12, 907.Google Scholar
Yarmesh, M., & Sheaford, M. (1984). The decision to restrain. Geriatric Nursing, 5, 242244.Google Scholar
4
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant*
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant*
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant*
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *