Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Feb 25:10:11.
doi: 10.1186/1471-2318-10-11.

Belt restraint reduction in nursing homes: design of a quasi-experimental study

Math J M Gulpers  1 , Michel H C Bleijlevens, Erik van Rossum, Elizabeth Capezuti, Jan P H Hamers
Affiliations

Belt restraint reduction in nursing homes: design of a quasi-experimental study

Math J M Gulpers et al. BMC Geriatr. .

Abstract

Background: The use of physical restraints still is common practice in the nursing home care. Since physical restraints have been shown to be an ineffective and sometimes even hazardous measure, interventions are needed to reduce their usage. Several attempts have been made to reduce the use of physical restraints. Most studies used educational approaches and introduced a nurse specialist as a consultant. However, the success rate of these interventions has been inconsistent. We developed a new multi-component intervention (EXBELT) comprising an educational intervention for nursing home staff in combination with a policy change (belt use is prohibited by the nursing home management), availability of a nurse specialist and nursing home manager as consultants, and availability of alternative interventions. The first aim of this study is to further develop and test the effectiveness of EXBELT on belt restraint reduction in Dutch psychogeriatric nursing homes. However, the reduction of belts should not result in an increase of other restrictive restraints (such as a chair with locked tray table) or psychoactive drug use. The overall aim is an effective and feasible intervention that can be employed on a large scale in Dutch nursing homes.

Methods and design: Effects of EXBELT will be studied in a quasi-experimental longitudinal study design. Alongside the effect evaluation, a process evaluation will be carried out in order to further develop EXBELT. Data regarding age, gender, use of physical restraints, the number of falls and fall related injuries, psychoactive drug use, and the use of alternative interventions will be collected at baseline and after four and eight months of follow-up. Data regarding the process evaluation will be gathered in a period of eight months between baseline and the last measurement. Furthermore, changing attitudes will become an important addition to the educational part of EXBELT.

Discussion: A quasi-experimental study is presented to investigate the effects of EXBELT on the use of belts on wards in psychogeriatric nursing homes. The study will be conducted in 26 wards in 13 psychogeriatric nursing homes. We selected the wards in a manner that contamination between control- and intervention group is prevented.

Trial registration: (NTR2140).

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study Design.
See this image and copyright information in PMC

References

    1. Hantikainen V. Physical restraint: a descriptive study in Swiss nursing homes. Nurs Ethics. 1998;5(4):330–346. - PubMed
    1. Hamers JP, Huizing AR. Why do we use physical restraints in the elderly? Z Gerontol Geriatr. 2005;38(1):19–25. doi: 10.1007/s00391-005-0286-x. - DOI - PubMed
    1. Meyer G, Kopke S, Haastert B, Muhlhauser I. Restraint use among nursing home residents: cross-sectional study and prospective cohort study. J Clin Nurs. 2009;18(7):981–990. doi: 10.1111/j.1365-2702.2008.02460.x. - DOI - PubMed
    1. Halfens RJG, Meijers JMM, Neyens JCL, Offermans MPW. Rapportage resultaten Landelijke Prevalentiemeting Zorgproblemen 2007. Maastricht: Universiteit Maastricht (Onderzoeksinstituut Caphri, Department of Healt Care and Nursing Sciences); 2007.
    1. IGZ a. Zorg voor vrijheid:terugdringen van vrijheidsbeperkende maatregelen kan en moet. Den Haag: IGZ; 2008.

Publication types