Use of Restraints and Bedrails in a British Hospital

Shaun T. O’Keeffe · Catherine I. A. Jack · Michael Lye

70 citations0/0 files storedJournal of the American Geriatrics Society

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Healthcare Decision-Making and Restraints Patient Safety and Medication Errors Intensive Care Unit Cognitive Disorders

Abstract

OBJECTIVE: To determine the prevalence of restraint and bedrail use in a British hospital. DESIGN: Cross-sectional observational study. SUBJECTS: Six hundred sixty-eight patients in the acute medical, surgical, and geriatric beds of a large British teaching hospital on a single night. MEASUREMENTS: Observed use of restraints and bedrails. Reasons for restraint use were determined by interviews with nursing staff and examination of the case notes. RESULTS: Fifty-six (8.4%) patients had bedrails raised. No other restraints were in use. Reported indications for bedrail use were: prevention of falls (52 patients), prevention of wandering (1), and patient request (3). In stepwise logistic regression analysis, bedrail use was associated significantly with agitated confusion, age 70 years or more, and stroke, while patients on the acute geriatric wards were significantly less likely to have bedrails raised. CONCLUSIONS: Restraint use is relatively uncommon in Britain. Nevertheless, inappropriate use of bedrails is a reason for concern.

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1989Tying Down the Elderly 1992Mechanical Restraint Use and Fall-related Injuries among Residents of Skilled Nursing Facilities 1988Physical Restraint of the Hospitalized Elderly 1989Physical Restraints and Agitation in Nursing Home Residents 1987Binding the Elderly: A Prospective Study of the Use of Mechanical Restraints in an Acute Care Hospital 1989A Further Exploration of the Use of Physical Restraints in Hospitalized Patients 1986Incidence of Physical Restraints on Acute General Medical Wards 1989Mechanical restraints on the medical wards: are protective devices safe?

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