Physical Restraint Use In Old Patients

Running head: PHYSICAL RESTRAINT USE IN OLD PATIENTS 1

Physical restraint use in old patients

Name

Institution

PHYSICAL RESTRAINT USE IN OLD PATIENTS 2

Physical restraint use in old patients

Research problem

Management of older patient in hospital is performed using physical restraints. Negative

results have been reported on the use of physical restraint, but research has been carried out to

investigate whether the physical restraints have an impact on how someone is supposed to stay in

hospital. Effects fall in the background of existing knowledge because it is vibrant that some

researcher has done some work regarding the issue which was addressed in the report.

The problem is relevant to nursing practice because it will enable them to determine

whether the use of physical restraints among old people affects their length of stay in the

hospital, it will assist nurses in coming up with the strategy on how to care and reduce the length

of stay of older patient the hospital where some nurses lack training and experience required (Bai

et.al, 2014). The aim of the research was to investigate how LOS in hospital is affected by

physical restraints in older inpatients.

Literature Review

Literature review tries to identify what have been done by other researchers on the topic

under study. Physical constraints refer to equipment attached to someone’s body which prevents

one from voluntary movement, and the person cannot remove it. Various restraints are used in

the hospital practice which is used to measure patient management and ensure that patient and

staff are well protected.

The use of physical restraints among the older people has raised significant concern on

ethical issues. Reports have suggested that use of physical restraints does not respect human

PHYSICAL RESTRAINT USE IN OLD PATIENTS 3

autonomy and it prevent the promotion of self-independence among the older people. Patients

have complained about the use of physical restraints because it makes them feel powerless and

insecure. It was reported that most patient with restraints experiences nightmares and lack of

sleep (Bai et.al, 2014). LOS is used to estimate resource utilization by inpatient care and

treatment outcomes. A lot of resources are utilized when patient stay for long in hospital. Since

the use of physical restraints can cause a mental problem inpatient, it’s reasonable to argue that

physical restraints can prolong LOS.

Theoretical Framework

The reports target to address the gap based on the number of patients who were admitted

to hospital in Hong Kong hence this help to show that theoretical concepts are related to study

reports. The research has explored the possible effect on how physical restraints affect length of

stay in hospital. The research draw on the nursing theory because it’s providing a clear

framework for nursing interventions and assisting in predicting outcomes in nursing practice.

Variables and Hypotheses

Age is one of the dependent variables in the study; this is because the research is

conducted to a patient who is over 60 years old. There is a direct relationship between the use of

physical restraint and the patient length of stay in the hospital. However, it has been criticized

that adverse outcomes such as nightmares and feeling of powerlessness may interfere with

treatment for restrained patients which may end up prolonging they stay in hospital practice

(Kwok et.al 2012). The research question is well stated in the study. It hypothesize that use of

physical restraint might contribute to prolonged length of stay in hospitals

Methodology

PHYSICAL RESTRAINT USE IN OLD PATIENTS 4

The methodology used for this project involved the use of a quantitative research method

which followed a thoughtful approach. Inductive method of reasoning was where multiple

logical premises which are all known to the nurses were brought together to come up with a

conclusion on the objective of the study. The goal of this study was to access whether there is a

direct link between the length of stay in hospitals and use of physical restraint. However, it is

known that there are several negative outcomes are associated with this nursing practice (Kwok,

et.al. 2012)

The samples used for the study were medical records from patients who had visited Hong

Kong public hospital in the year 2007. By use of SPSS, the 1000 patient’s records were

randomly selected from a pool of 3736 patients (Bai et.al, 2014). Form the 1000 only 90 medical

records were disqualified leaving 910 which were used in this study since these 910 records of

patients were above the age of 60. The setting for this study was in a convalescence and

rehabilitation hospital so as to be able to obtain patients multiple pathologies and their general

health information.

The investigators opted to use probability sampling technique for this case which

involved such techniques such as SPSS. Different measurement tools were used for this research

such as demographic characteristics all of which showed validity and reliability. The validation

was done and based on the previous studies whereas reliability of the process was confirmed by

satisfactory Cronbach’s alpha coefficients.

For this research to be conducted, there was an ethical consideration that needed

attention. For one the study protocol which required the hospital to share confidential

information had to be approved by the clinical research ethics committee. Moreover,

PHYSICAL RESTRAINT USE IN OLD PATIENTS 5

confidentially of the patient information was also key in this study to ensure it was only used for

research purposes.

Data Analysis

SPSS version 15 was used in this research for data analysis. A series of other methods of

data analysis were conducted to ensure that the data obtained was correct. For one, descriptive

analyses were done followed, by bivariate analysis, then parson’s correlation and finally the

hierarchical linear regression analysis.

The results of the study were presented by recording characteristics of the patients such

as general health status and cognitive function. Furthermore, the correlation linking the Length

of Stay (LOS) to health predictors was also presented in the results and finally the data obtained

from the LOS hierarchical regression analysis.

The results obtained proved that patient characteristics such as general health status,

physical and cognitive function affected LOS. It was also found out that physical restraint use

translates to longer LOS thus it should be used with cautiously. However, LOS, on the other

hand, is a potential strategy that can be used to enhance the service offered in the hospitals.

Summary/Conclusions, Implications, and Recommendations

The strength of the study was the broad database of patient’s records where the

researchers were able to pick 1000 records of the patients comfortably. Furthermore, the patient

records picked randomly fitted well in the research as 910 out of 1000 of the medical records

were from patients aged above 60 years which are quite relevant to the study (Bai et.al, 2014).

However, there are several limitations at hand in this study such as the cross-sectional design that

was used. Because the longitudinal design was utilized in the research, it makes it difficult for

PHYSICAL RESTRAINT USE IN OLD PATIENTS 6

the researchers to warrant the relationship between LOS and physical restraint use. Also, the

model concentrated more on the physical well-being of patients and their health. Furthermore,

there was bias in findings as the use of bedrail was under reported and documentation of hand

mitten was not properly done.

In the findings, there was no generalizing to other populations. The research was

conducted based on old people. Additionally, people’s records and data entry, gender age, and

accommodation reflected in the files. However, old people are the ones who were fog to have

much physical restraint. In the year 2007, many individuals were 60 age and above who were

physically restrained. By 2011 the number had drastically risen creating a lot of worries for many

people.

However, the findings that were done and used in the study were to address the issue on

the length of stay in hospitals. Data collection, measurement of the time taken by the patients in

hospitals were made to evaluate the important outcome in the hospitals.

The length of stay in hospital is a global challenge facing many nations. However,

physical restraint has been found as the major factor that contributes to a longer stay in hospitals,

especially for old people. Physical restraint is any restriction to the freedom of movement of a

person. The challenge is discussed in the study of a public hospital Hong Kong. The research

conducted was a fundamental aspect of nursing since could help establish the primary causes of

the extended stay in hospitals. It also helps the doctors to determine the better step to take to

examine the patients.

PHYSICAL RESTRAINT USE IN OLD PATIENTS 7

References

Bai, X., Kwok, T. C., Ip, I. N., Woo, J., Chui, M. Y., & Ho, F. K. (2014). Physical restraint use

and older patients’ length of hospital stay. Health Psychology and Behavioral Medicine:

an Open Access Journal, 2(1), 160-170.

Kwok, T., Bai, X., Chui, M. Y., Lai, C. K., Ho, D. W., Ho, F. K., & Woo, J. (2012). Effect of

physical restraint reduction on older patients’ hospital length of stay. Journal of the

American Medical Directors Association, 13(7), 645-650.

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