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Low nurse numbers could increase hospitals’ use of restraint – study

US study shows proportion of nurses on wards influences use of restraint.
hospital patient

Low numbers of nurses on hospital wards could lead to increased use of restraint, a US study suggests.

Research published in the Journal of General Internal Medicine found that the use of belts, bed rails and other devices to prevent patients from hurting themselves was linked to the number of registered nursing staff on shift. The higher the proportion of registered to unregistered staff on a shift, the less likely it was that restraint would be used.

Low nurse staffing

Data analysis on the care of more than 923,000 patients in 869 US hospitals over a four-year period found restraint was used on 1.6% of patients.

When a units percentage of registered nursing staff was low or very low relative to the units staffing average, the odds of restraint being used were 11% and 18% higher respectively.

In half (51%) of cases, the reported purpose of

Low numbers of nurses on hospital wards could lead to increased use of restraint, a US study suggests.

Research published in the Journal of General Internal Medicine found that the use of belts, bed rails and other devices to prevent patients from hurting themselves was linked to the number of registered nursing staff on shift. The higher the proportion of registered to unregistered staff on a shift, the less likely it was that restraint would be used.

Low nurse staffing

Data analysis on the care of more than 923,000 patients in 869 US hospitals over a four-year period found restraint was used on 1.6% of patients.

When a unit’s percentage of registered nursing staff was low or very low relative to the unit’s staffing average, the odds of restraint being used were 11% and 18% higher respectively.

In half (51%) of cases, the reported purpose of restraint was to prevent the patient from falling.

Restraint avoidance

Study author Vincent Staggs, of Children’s Mercy Hospital in Kansas City and the University of Missouri-Kansas City, said the findings suggest nurses are better trained to find alternatives to restraint than unregistered staff.

‘Patient care quality may suffer when unit staffing models cannot respond to changes in patient volume or registered nurse availability except by increasing the hours of staff who are not registered nurses,’ he added.

‘This is further evidence that the type of nursing staff, not just the number of staff per patient, can be important for patient outcomes.’

More nurses, safer outcomes

RCN professional lead for older people and dementia care Dawne Garrett said it was important to bear in mind there were significant differences in the methods of restraint between US and UK hospitals.

‘It is quite unusual to use mechanical restraints in an acute setting in the UK for example,’ she said.

But she added it was unsurprising to find an increase in the number of registrants had a positive effect.

‘We know having high numbers of registered nurses means safer outcomes for patients though that we haven’t looked at how that impacts restraint here in the UK.

‘But it makes sense that someone with a high level of skill in that situation means that patients are going to have a more relaxed and appropriate stay.’

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