Attitudes to restraint for the prevention of falls in hospital

This source preferred by Stephen Allen and Roger Baker

Authors: Vassallo, M., Wilkinson, C., Stockdale, R., Malik, N., Baker, R. and Allen, S.C.

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Journal: Gerontology

Volume: 51

Pages: 66-70

ISSN: 0304-324X

DOI: 10.1159/000081438

Introduction: Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. Methods: A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. Results: Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: ‘restraint should always be an option in patients if the patient is at risk of falling’ (82 vs. 45%; p < 0.0001), ‘restraining methods are acceptable at the discretion of care professionals’ (91 vs. 43%; p < 0.0001), ‘restraint is an infringement of personal freedom’ (35 vs. 66%; p < 0.0001) and ‘restraint is necessary if it frees staff to do more clinical work’ (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. Conclusions: When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society’s values. Such information is important to formulate informed fall prevention... [ABSTRACT FROM AUTHOR]

This data was imported from PubMed:

Authors: Vassallo, M., Wilkinson, C., Stockdale, R., Malik, N., Baker, R. and Allen, S.

Journal: Gerontology

Volume: 51

Issue: 1

Pages: 66-70

ISSN: 0304-324X

DOI: 10.1159/000081438

INTRODUCTION: Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. METHODS: A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. RESULTS: Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: 'restraint should always be an option in patients if the patient is at risk of falling' (82 vs. 45%; p < 0.0001), 'restraining methods are acceptable at the discretion of care professionals' (91 vs. 43%; p < 0.0001), 'restraint is an infringement of personal freedom' (35 vs. 66%; p < 0.0001) and 'restraint is necessary if it frees staff to do more clinical work' (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. CONCLUSIONS: When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society's values. Such information is important to formulate informed fall prevention policies.

This data was imported from Scopus:

Authors: Vassallo, M., Wilkinson, C., Stockdale, R., Malik, N., Baker, R. and Allen, S.

Journal: Gerontology

Volume: 51

Issue: 1

Pages: 66-70

ISSN: 0304-324X

DOI: 10.1159/000081438

Introduction: Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. Methods: A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. Results: Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: 'restraint should always be an option in patients if the patient is at risk of falling' (82 vs. 45%; p < 0.0001), 'restraining methods are acceptable at the discretion of care professionals' (91 vs. 43%; p < 0.0001), 'restraint is an infringement of personal freedom' (35 vs. 66%; p < 0.0001) and 'restraint is necessary if it frees staff to do more clinical work' (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. Conclusions: When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society's values. Such information is important to formulate informed fall prevention policies. Copyright © 2005 S. Karger AG, Basel.

This data was imported from Web of Science (Lite):

Authors: Vassallo, M., Wilkinson, C., Stockdale, R., Malik, N., Baker, R. and Allen, S.

Journal: GERONTOLOGY

Volume: 51

Issue: 1

Pages: 66-70

eISSN: 1423-0003

ISSN: 0304-324X

DOI: 10.1159/000081438

This data was imported from Europe PubMed Central:

Authors: Vassallo, M., Wilkinson, C., Stockdale, R., Malik, N., Baker, R. and Allen, S.

Journal: Gerontology

Volume: 51

Issue: 1

Pages: 66-70

eISSN: 1423-0003

ISSN: 0304-324X

INTRODUCTION: Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. METHODS: A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. RESULTS: Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: 'restraint should always be an option in patients if the patient is at risk of falling' (82 vs. 45%; p < 0.0001), 'restraining methods are acceptable at the discretion of care professionals' (91 vs. 43%; p < 0.0001), 'restraint is an infringement of personal freedom' (35 vs. 66%; p < 0.0001) and 'restraint is necessary if it frees staff to do more clinical work' (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. CONCLUSIONS: When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society's values. Such information is important to formulate informed fall prevention policies.

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