Organizational characteristics and restraint use for hospitalized nursing home residents.

Format:

Book

Thesis/Dissertation

Author/Creator:

Bourbonniere, Mary Giblin.

Contributor:

Strumpf, Neville E., advisor.

University of Pennsylvania.

Language:

English

Subjects (All):

Nursing.

0569.

Penn dissertations--Nursing.

Nursing--Penn dissertations.

Local Subjects:

Penn dissertations--Nursing.

Nursing--Penn dissertations.

0569.

Physical Description:

77 pages

Contained In:

Dissertation Abstracts International 62-11B.

System Details:

Mode of access: World Wide Web.

text file

Summary:

Frail older nursing home residents are particularly vulnerable to physical restraint during hospitalization. Over the past ten years, federal agencies and professional organizations have advocated the reduction or elimination of physical restraints in acute care. Understaffing remains a consistent theme in the literature on restraint use in hospitals although relationships between organizational characteristics and restraint use have rarely been tested. The purpose of this study was to examine the impact of organizational characteristics on physical restraint use for hospitalized nursing home residents. This secondary analysis used data from a clinical trial employing an advanced practice nurse (APN) intervention to reduce restraint use in hospitalized nursing home residents. Using generalized estimating equations, three models were constructed to evaluate relationships between unit-level organizational characteristics (day of week, patient registered nurse ratio, patient-total nursing staff ratio, and skill mix) and restraint use for 174 nursing home residents over 1085 inpatient days. Controlling for the APN intervention, age, and patient behavioral characteristics (all of which increased the likelihood of restraint use), weekend days as an organizational characteristic significantly increased the odds of restraint. (Weekend day and patient-RN ratio on physical restraint use: OR: 1.92, 95% CI: 1.38, 2.68, p = 0.0001; Weekend day and patient-total staff ratio on physical restraint use: OR: 1.91, 95% CI: 1.37, 2.66, p = 0.0001; Weekend day and skill mix on physical restraint use: OR: 1.91, 95% CI: 1.37, 2.67, p = 0.0001). The key findings suggest that organization of hospital care on weekends and patient characteristics that affect communication ability, such as severely impaired mental state, English as a second language, sedation, or sensory-perceptual losses, may be overlooked variables in restraint use.

Notes:

Thesis (Ph.D. in Nursing) -- University of Pennsylvania, 2001.

Source: Dissertation Abstracts International, Volume: 62-11, Section: B, page: 5031.

Supervisor: Neville E. Strumpf.

Local Notes:

School code: 0175.

ISBN:

9780493441061

Access Restriction:

Restricted for use by site license.