Using restraint with nursing home residents: a qualitative study of nursing staff perceptions and decision-making

Authors

  • Virpi Hantikainen RN MNSc,

    1. Doctoral Candidate, Department of Nursing Science, University of Turku, Finland and Lecturer, Swiss Association for Nurses, Education Centre, Zürich, Switzerland
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  • Silvia Käppeli RN PhD Dr Phil

    1. Director, Department for Nursing Research and Development, University Hospital Zürich, Zürich, Switzerland
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VirpiHantikainen Sonnenstrasse 23, CH-5415 Nussbaumen, Switzerland. E-mail: rv_hantikainen@datacomm.ch

Abstract

Using restraint with nursing home residents: a qualitative study of nursing staff perceptions and decision-making

The study reported in this paper applied a qualitative and interpretative approach to nursing staff perceptions of the use of restraint with elderly nursing home residents, and into nurses’ decision-making on restraint use. The data were collected using unstructured interviews with a purposive sample of 20 trained and untrained nursing staff from two Swiss nursing homes. Data analysis was based on Colaizzi’s phenomenological method. Three main themes were extracted from the data: (1) understanding the term restraint, (2) situations in which the decision to apply restraint is considered justified and (3) situations in which nursing staff are uncertain about the use of restraint. The underlying bases with respect to decision-making were: understanding restraint, the rights and responsibilities of both residents and staff, and the duties of staff. Staff members were ambiguous in their understanding of restraint and they showed positive as well as confused attitudes towards its use. Their behaviour was defensive and protective rather than challenging. Further research is required on what is meant by safety in care of the elderly nursing today. In nursing practice, as far as issues of restraint are concerned, greater attention should be devoted to the relationship between elderly residents’ self-determination and responsibility for their actions.

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