Factors related to the physical restriction practiced by nurses in acute care hospitals: An analysis using nurses’ self-assessment

Abstract

Aim: The purpose of this study was to clarify the relationship between physical restriction as a nursing practice and the perceived extent of person-centered care towards elderly patients with cognitive impairment in acute care hospitals (SSNPEC). Research methods: This study was conducted on ward nurses in 4 hospitals (nursing staff ratio of 7:1; >500 beds) in H city from April 2016 to March 2017. The evaluation of physical restriction in the hospital comprised the following six items: The use of trunk belts, wearing of mitten-type gloves, the use of shoulder harnesses (such as for patients in wheelchairs), wearing care clothes, the use of a bed fence, and psychotropic drugs. In the multiple regression analysis, the total physical restriction score was the dependent variable. Results pertaining to the prediction of physical restriction were as follows: “Care that values psycho-social approaches based on predicted potential problems”, “Care that is tailored to the individual and their cognitive function”, and “Improvement in the quality of the care” significantly decreased physical restrictions. Conclusion: This study showed that nursing practices in acute care hospitals that are based on person-centered care emphasizing clinical ethics decreased the application of physical restrictions. A balance existed between safety management through nursing practices and respect for patients in acute hospitals.