HOSPITAL STAFFING, RESTRAINTS, AND FRAIL OLDER ADULTS

University Of Pennsylvania, Philadelphia PA

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Abstract

In hospitals, physical restraints are used more frequently with older adults. No benefits of physical restraint are known, while negative outcomes are well documented. Existing research suggests that nurses, physicians, and families consider lower registered nurse (RN) staffing a critical factor in restraint use. Nevertheless, no studies have examined the relationship between RN staffing and restraint use. The purpose of the proposed study is to examine the impact of work redesign and staffing characteristics (RN-patient ratio, staff skill mix) on physical restraint use in hospitalized nursing home residents, controlling for the APN intervention and patient characteristics (fall risk, behavioral phenomena, treatment interference, cognitive function, severity of illness). It is hypothesized that the absence of work redesign and a higher RN-patient ratio and a higher percentage of RN staff will predict lower physical restraint use. The findings of this secondary analysis will provide information on the relationship between staffing patterns and use of physical restraints, will contribute relevant empirical data related to policy and on the organization and delivery of nursing care in hospitals, and support emerging standards of care related to physical restraint use.