Characteristics of nursing home residents and physical restraint: a systematic literature review
Article first published online: 11 OCT 2013
© 2013 John Wiley & Sons Ltd
Journal of Clinical Nursing
Volume 23, Issue 21-22, pages 3012–3024, November 2014
How to Cite
Hofmann, H. and Hahn, S. (2014), Characteristics of nursing home residents and physical restraint: a systematic literature review. Journal of Clinical Nursing, 23: 3012–3024. doi: 10.1111/jocn.12384
- Issue published online: 13 OCT 2014
- Article first published online: 11 OCT 2013
- Manuscript Accepted: 1 APR 2013
- Berne University of Applied Sciences
- St. Gallen University of Applied Sciences
- nursing homes;
- physical restraint
Aims and objectives
To analyse and to summarise factors associated with nursing home residents' characteristics which could lead to physical restraint, and to investigate the consequences of physical restraint use for this population.
Even though the application of physical restraint is highly controversial, prevalence rates show that it is a common intervention in nursing homes. Residents' characteristics seem to be important to predict the use of physical restraint. Evidence suggests that restrained nursing home residents may have physical and psychological disadvantages as a consequence of being restrained.
A systematic literature research involving the databases PubMed, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Science and Cochrane Library was carried out for articles published from January 2005–November 2011. Nine Studies fulfilled the inclusion criteria and the quality assessment.
Restrained residents had low activities of daily living (ADL) scores and severe cognitive impairment. Residents with low cognitive status and serious mobility impairments were at high risk to be restrained, as well as residents with previous fall and/or fracture. Repeated verbal and physical agitation was found to be positively associated with restraint use. Possible consequences of physical restraint were as follows: lower cognitive and ADL performance, higher walking dependence, furthermore falls, pressure ulcers, urinary and faecal incontinence.
This systematic literature review reveals notable resident-related factors for physical restraint use. The consequences of restraint seem to negatively influence residents' physical and psychological well-being. Physical restraint seems to be an important risk factor for residents' further health problems.
Relevance to clinical practice
Resident's characteristics appear to be decisive factors for the use of physical restraint. Nurses need a high level of expertise and competence in evaluating the individual residents′ situation and deciding further steps, with respect for the autonomy and dignity of the person.