Evangelische Hochschule Berlin, Berlin, Germany.
J Clin Nurs. 2012 Apr;21(7-8):1033-40. doi: 10.1111/j.1365-2702.2011.03931.x. Epub 2011 Dec 19.
The aim of the study was to investigate factors related to the use of restraints and to explore whether the rate of nurses was an influencing factor regarding the use of restraints in German nursing homes and hospitals.
Restraints are frequently used measures in hospitals and nursing homes. Risks for falls and small nurse workforces are discussed in relation to the use of restraints.
A secondary analysis of a cross-sectional study was carried out. Methods. Data were collected by trained nurses using standardised questionnaires in 76 nursing homes (n = 5521) and 15 hospitals (n = 2827). For data analysis, a 3-level random intercept logistic model was used.
The prevalence of restraints (bed rails and/or belts) was 9·3% for hospital patients and 26·3% for nursing home residents. Amongst hospital patients, restraint use was more prevalent in women, older patients, patients with a high care dependency, patients who fell during the last two weeks, patients with a perceived risk of falls, polypharmacy, urinary incontinence, disorientation and confinement to bed. In the nursing homes, the restrained residents were significantly younger, more care dependent, had less falls and were more often urinary incontinent, disoriented and bedfast. The rate of nurses was not significantly related to the use of restraints in hospitals, and nursing homes according to the three-level random intercept model.
Hospital patients with previous falls were more often restrained, but in the nursing homes, the restrained residents experienced less falls. The number of qualified nursing staff had no significant influence on the use of physical restraints.
Lower nurse staffing ratios were not related to higher frequencies of restraint use in this study.
本研究旨在调查与约束使用相关的因素，并探讨护士人数是否是影响德国疗养院和医院约束使用的因素。
约束是医院和疗养院常用的措施。与约束使用相关的风险包括跌倒风险和护士人员短缺。
对一项横断面研究进行了二次分析。方法。由经过培训的护士使用标准化问卷在 76 家疗养院（n=5521）和 15 家医院（n=2827）中收集数据。为了数据分析，使用了 3 级随机截距逻辑模型。
医院患者的约束（床栏和/或安全带）使用率为 9.3%，疗养院居民为 26.3%。在医院患者中，女性、年龄较大、护理依赖性较高、过去两周内跌倒、有跌倒风险感知、多药治疗、尿失禁、定向障碍和卧床不起的患者更常使用约束。在疗养院中，受约束的居民明显更年轻、护理依赖性更高、跌倒次数更少，且更常出现尿失禁、定向障碍和卧床不起。根据三级随机截距模型，护士人数与医院和疗养院约束的使用没有显著相关。
过去有跌倒史的医院患者更常被约束，但在疗养院中，受约束的居民跌倒次数更少。合格护理人员的数量对身体约束的使用没有显著影响。
在这项研究中，较低的护士人员配备比例与约束使用频率的增加无关。
