Mayumi Makino, Mayumi Kato, Sanae Naruse, Yukari Yoshie, Koji Eda
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引用次数: 0
Abstract
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.
期刊介绍:
The Japan Journal of Nursing Science is the official English language journal of the Japan Academy of Nursing Science. The purpose of the Journal is to provide a mechanism to share knowledge related to improving health care and promoting the development of nursing. The Journal seeks original manuscripts reporting scholarly work on the art and science of nursing. Original articles may be empirical and qualitative studies, review articles, methodological articles, brief reports, case studies and letters to the Editor. Please see Instructions for Authors for detailed authorship qualification requirement.