Köpke Sascha, Meyer Gabriele, Haut Antonie, Gerlach Anja
Universität Hamburg, MIN-Fakultät, Fachwissenschaft Gesundheit, Martin-Luther-King-Platz 6, 20146 Hamburg.
Z Evid Fortbild Qual Gesundhwes. 2008;102(1):45-53. doi: 10.1016/j.zgesun.2007.12.003.
Physical restraints are routinely used in nursing home residents in Germany. Bedrails are applied to at least one of four residents. Belts, fixed tables and other measures are less frequent but are still used as routine measures. So far, beneficial effects of the use of physical restraints have not been shown, negative effects are likely. A recently completed observational study in 30 nursing homes in Hamburg showed great variations between centres concerning the frequency of restraint use. An evidence-based practice guideline could be the appropriate measure to reduce physical restraints and overcome centre variations. Currently, there are no evidence-based practice guidelines for the avoidance of physical restraints in nursing homes. This applies to nursing practice in Germany in general. The "German Network for Quality Development in Nursing (DNQP)" deliberately distinguishes their so-called "national expert standards" from "medical" practice guidelines. Funded by the German Ministry of Education and Science, a project aiming to develop an evidence-based practice guideline on the avoidance of physical restraints in nursing homes, for the first time applies internationally discussed methods to a nursing guideline in Germany. This article describes the methodological framework, instruments and processes of the guideline's development.
在德国，养老院的居民经常会使用身体约束措施。至少每四名居民中就有一人会使用床栏。腰带、固定餐桌和其他措施使用频率较低，但仍作为常规措施使用。到目前为止，尚未证明使用身体约束措施有有益效果，负面影响却很可能存在。最近在汉堡的30家养老院完成的一项观察性研究表明，各中心在约束措施使用频率方面存在很大差异。基于证据的实践指南可能是减少身体约束措施并克服各中心差异的适当措施。目前，在养老院中尚无关于避免使用身体约束措施的基于证据的实践指南。这在德国的护理实践中普遍存在。“德国护理质量发展网络（DNQP）”特意将其所谓的“国家专家标准”与“医学”实践指南区分开来。由德国教育和科学部资助的一个项目，旨在制定一项关于养老院避免使用身体约束措施的基于证据的实践指南，首次将国际上讨论的方法应用于德国的护理指南。本文描述了该指南制定的方法框架、工具和过程。
