Effectiveness of educational interventions on restraint minimisation in elderly persons in long-term care.

Abstract

Restraint, particularly in long-term care institutions, is being questioned. The elderly are experiencing a decreased quality of life, thus, being deprived from their dignity, right of autonomy and non-maleficence. The caring staff is experiencing internal and external conflicts related to restraint use while practicing. Consequently, there is a need of a paradigm shift towards minimising restraint usage or adopting restraint-free care. It is imperative that the caring professionals are educated and trained on the subject. The purpose of this study was to investigate whether educational programmes on restraint use addressed to nursing staff working in long-term care facilities will impact their attitudes and beliefs in minimising restraint use. Therefore, the proposed research question guiding this study is: "Among nursing staff working in geriatric settings, does an educational programme on the use of restraints with elderly persons in long-term care result in the minimisation of restraint use?" An investigation was conducted through an Evidence Based Health Care enquiry for articles related to the research question. Since the selection criteria included only RCTs/CRCTs, from the search strategy that provided twenty studies, thirteen RCTs/CRCTs were selected and critically appraised using the Critical Appraisal Skills Program (CASP). The result from this investigation showed that extended educational programmes with expert support, delivered by formally trained restraint experts that supervise and support the caring staff, should be considered for the local context. It is recommended that such educational programme should be delivered to anyone providing care in all elderly settings. Moreover, dissemination of knowledge on restraint use should be delivered to all students of the various disciplines attending the faculty of health science. Furthermore, such information should also be delivered periodically to all caring staff working in the private/church residential homes and day-care centres. Finally, the public in general should also be educated on such an issue, through the various local communication media, to convey awareness of what restraint entails and its consequences.