Does access to bed chair pressure sensors reduce physical restraint use in the rehabilitative care setting?

  • Kwok T
  • Mok F
  • Tong Chien W
 et al. 
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Abstract

Background - the common use of physical restraints in older people in hospitals and nursing homes has been associated with injurious falls, decreased mobility and disorientation. By offering access to bed chair pressure sensors in hospitalised patients with perceived fall risk, nurses may be less inclined to resort to physical restraints, thereby improving clinical outcomes. Aims and objectives - to investigate whether the access of bed chair pressure sensors reduces the physical restraint use in geriatric rehabilitation wards. Design - randomised controlled trial Methods - consecutively, patients admitted to two geriatric wards specialised in stroke rehabilitation in a convalescent hospital in Hong Kong, and who were perceived by nurses to be at risk of falls were randomly assigned to intervention and control groups. For the intervention group, nurses were given access to bed chair pressure sensors. These sensors were not available to control group subjects, as in usual practice, The trial continued until discharge. The primary outcomes were the proportion of subjects restrained by trunk restraint, bedrails or chair board and the proportion of trial days in which each type of physical restraint was applied. The secondary outcomes were the proportions of those who improved in the mobility and transfer domains of modified Barthel index on discharge and of those who fell. Results - one hundered and eighty subjects were randomised. Fifty (55.6%) out of the 90 intervention group subjects received the intervention. There was no significant difference between the intervention and control groups in the proporotions and duration of having the three types of physical restraints. There was also no grouped difference in the chance of improving in mobility and transfer ability, and of having a fall. Conclusion - access to bed chair pressure sensor device neither reduced the use of physical restraints nor improved the clinical outcomes of older patients with perceived fall risk. Relevance to clinical practice - the provision of bed chair pressure sensors may only be effective in reducing physical restraints when it is combined with an organised physical restraint reduction programme.

Author-supplied keywords

  • acccidental falls
  • bed
  • care setting
  • chair
  • elderly
  • nursing
  • physical
  • pressure sensors
  • restraint
  • telemetry

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Authors

  • T Kwok

  • F Mok

  • W Tong Chien

  • E Tam

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