Nursing Working Conditions in Relation to Restraint Practices in Long-Term Care Units

Datos Bibliográficos

ID9102325
AutoresLaura Pekkarinen (0000-0002-5596-0485, Research Council of Finland), Marko Elovainio (0000-0002-1401-1910, Research Council of Finland), Timo Sinervo (0000-0003-4475-0797, Research Council of Finland), Harriet Finne-Soveri, Harriet Finne‐Soveri (0000-0001-8836-1860, Research Council of Finland), Anja Noro (Research Council of Finland)
Año2006
Volumen44
Número12
Páginas1114-1120
Fecha de publicación2006-12-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000237198.90970.64
PMID17122716
OpenAlexW1976130736
IdiomaEN
Citas recibidas2
Referencias citadas43

OBJECTIVES: This study examined the effects of nursing working conditions on the use of physical restraints and antipsychotics as restraints in long-term care units for elderly residents. DESIGN: Cross-sectional data were obtained in Finland in 2002 from long-term care units that used the Resident Assessment Instrument (RAI) system and participated in a survey on working conditions. SETTING: A sample of 91 inpatient units in 31 facilities (23 residential homes and 8 health centers). PARTICIPANTS: Data included 2430 resident assessments and 977 nursing staff survey responses. MEASUREMENTS: We measured unit-level mean scores of physical restraint and antipsychotics use as restraints and resident characteristics (activities of daily living, cognitive impairment, and daily behavioral problems) based on the RAI system as measured by the Minimum Data Set 2.0. Head nurses reported the structural factors (nurse staffing levels and unit size). Nursing working conditions were measured by the Job-Demands and Job-Control Scales in the staff survey questionnaire. RESULTS: Controlling for resident characteristics, nurses' job demands and control had a combined effect on restraint practices. Job demands strongly increased the risk of physical restraint use in units where nurses reported low job control (odds ratio [OR] = 13.31, 95% confidence interval [CI] 1.55-114.30, P = 0.019), but not among high-control units (OR = 0.23, 95% CI 0.04-1.29, P = 0.090). Although the use of antipsychotics was not related to job demands in units with low control (OR = 1.11, 95% CI 0.26-4.99, P = 0.891), the antipsychotics use in particular decreased when high job demands were coupled with high job control (OR = 0.17, 95% CI 0.03-0.91, P = 0.038). CONCLUSION: The results suggest that restraint use can be reduced by enhancing working conditions so that the nursing staff has possibilities for skill usage and decision-making

Confidence interval · Cross-sectional study · Long-term care · Minimum Data Set · Nursing Assistant · Nursing homes · Odds ratio · Staffing · Unit (ring theory) · Geriatric Care and Nursing Homes · Healthcare Decision-Making and Restraints · Intensive Care Unit Cognitive Disorders · Medicine · Nursing · Psychology