Physical restraint use among nursing home residents: A comparison of two data collection methods
Repository Posting Date2017-06-08T18:43:23Z
Lead Author Sigma AffliationNon-member
Level of EvidenceN/A
Keywordsphysical restraints; nursing home patients; Nursing Home Patients; Restraint, Physical--Utilization--In Old Age; Restraint, Physical--Utilization; Restraint, Physical
CINAHL HeadingsNursing Home Patients; Restraint, Physical--Utilization--In Old Age; Restraint, Physical--Utilization; Restraint, Physical
In view of the issues surrounding physical restraint use, it is important to have a method of measurement as valid and reliable as possible. We determined the sensitivity and specificity of physical restraint use a) reported by nursing staff and b) reviewed from medical and nursing records in nursing home settings, by comparing these methods with direct observation.
We sampled eight care units in skilled nursing homes, seven care units in nursing homes and one long-term care unit in a hospital, from eight facilities which included 28 nurses and 377 residents. Physical restraint use was assessed the day following three periods of direct observation by two different means: interview with one or several members of the regular nursing staff, and review of medical and nursing records. Sensitivity and specificity values were calculated according to 2-by-2 contingency tables. Differences between the methods were assessed using the phi coefficient. Other information collected included: demographic characteristics, disruptive behaviors, body alignment problems, cognitive and functional skills.
Compared to direct observation (gold standard), reported restraint use by nursing staff yielded a sensitivity of 87.4% at a specificity of 93.7% (phi = 0.84). When data was reviewed from subjects' medical and nursing records, sensitivity was reduced to 74.8%, and specificity to 86.3% (phi = 0.54). Justifications for restraint use including risk for falls, agitation, body alignment problems and aggressiveness were associated with the use of physical restraints.
The interview of nursing staff and the review of medical and nursing records are both valid and reliable techniques for measuring physical restraint use among nursing home residents. Higher sensitivity and specificity values were achieved when nursing staff was interviewed as compared to reviewing medical records. This study suggests that the interview of nursing staff is a more reliable method of data collection.
DescriptionDL participated in the second line of statistical analyses, and drafted the manuscript. PV drafted parts of the document and contributed to the editing. RV contributed to the editing of the manuscript. PJD served as the Principal Investigator, designed the study, participated and oversaw field activity, revised and edited the manuscript. All authors read and approved the final manuscript. We are grateful to Diane Richard, RN, for expert advice and assistance during data collection. We also recognize the work of Josée Bourdages, PhD, for assistance during data collection, and of Claude Lapointe, MSc, and Zohra Benounissa, MScA, for statistical assistance.
Date of Publication2004-10-15
Citation of Original PublicationLaurin, D., Voyer, P., Verreault, R., & Durand, P. J. (2004). Physical restraint use among nursing home residents: A comparison of two data collection methods. BMC Nursing 3 (1). DOI: 10.1186/1472-6955-3-5. Retrieved from http://www.nursinglibrary.org/vhl/handle/10755/621466
ISSN: BMC Nursing
Version of PublicationPublisher's version
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