Construction Of An Evidence-based Physical Restraint Education And Training Program For Nursing Staff In Nursing Home

Objective:1.To screen,evaluate,extract and synthesize the practical evidence of physical restraint education and training of nursing staff in aged care facilities,and formulate a evidence synthesis on physical restraint education and training for nursing staff in aged care facilities.2.To investigate the current situation of physical restraint education and training of nursing staff in aged care facilities in Hunan Province,and to understand the nurses’ cognition of physical restraint.3.To understand the needs on physical restraint education and training of nursing staff in aged care facilities.4.Based on the previous study results and the expert panel meeting,the physical restraint education and training program for nurses in aged care facilities in China was constructed.Method:1.Formulation of evidence synthesis for physical restraint education and training of nurses in aged care facilities: Searching,analyzing,screening and evaluating the literature,summing up the relevant evidence of physical restraint education and training for nursing staff in aged care facilities,and the preliminary evidence synthesis was construct with the revision of evidence-based experts.2.Investigation of physical restraint education and training of nursing staff in aged care facilities:The convenience sampling method was used to conduct a pre-survey of 50 nursing staff in a pension institution to test whether the design of the questionnaire was reasonable.Then,nursing staff in the mentally disabled area from 8 aged care facilities in east,south,west and north of Hunan province was selected by stratified cluster random sampling.And a total of 524 questionnaires were collected.Descriptive statistical analysis method was used to describe the current situation of physical restraint training of nursing staff in aged care facilities,and one-way analysis of variance was used to compare multi-sample averages of the characteristics of nursing staff to determine whether there were statistical differences in the cognitive score of physical restraint.3.Qualitative research on the needs of physical restraint education and training for nursing staff in aged care facilities: With objective sampling method,18 nursing staff from one public aged care facility and one private aged care facility in Changsha were selected as the research object to conduct semi-structured individual in-depth interviews.The interview data were transcribed and encoded verbally,and Colaizzi seven-step analysis method was used to analyze the information.4.Construction of physical restraint education and training program for nursing staff in aged care facilities: Based on the contents of the evidence synthesis,the investigation of physical restraint training and the results of training needs of nursing staff,the preliminary draft of the training plan was demonstrated and revised by the method of expert meeting,and final program of physical restraint education and training for nursing staff in aged care facilities was constructed.Result:1.A total of 18 literatures were included in this study,including 2 evidence-based guidelines,1recommended practice,11 systematic reviews,2 expert consensus,2 random controls.25 pieces of evidence were extracted and the evidence content is divided into 3 dimensions and 9 topics.2.Among the 524 nursing staff surveyed,97.1% said they had participated in physical restraint-related training,and 98.5% of them said they had participated in physical restraint training in the past three years.Among the contents of restraint training for nursing staff for the aged,there are mainly three contents: the type and use of constraint tools,the purpose of using restraints and the nursing of restraints.The average score of physical constraint cognition of nursing staff for the aged was(4.07 ±0.76).The results of one-way analysis of variance showed that there were significant differences in the cognitive scores of physical restraint among nurses with different ways of employment,frequency of physical restraint on the elderly and the aged care facility properties(P < 0.05).3.According to the data analysis,five topics are extracted: single knowledge of physical restraint,lack of pertinence in restraint practice,necessity of restraint training,simple and fragmented training content,learning thinking weakness of nursing staff,and lack of standardization of training and assessment.4.The framework of the program consists of three aspects: training method,training level and training evaluation.Training method included theoretical teaching,operation demonstration and clinical practice.The training level was composed of theoretical knowledge,knowledge application,operation performance and clinical performance.Training evaluation comprehensively evaluates the training effect from four levels: response layer,learning layer,behavior layer and achievement layer.There are five training topics in the training content:restraint knowledge,pre-restraint evaluation,restraint implementation,in-restraint nursing and post-constraint nursing.The quality coefficient of experts in the meeting is 0.818.Conclusion:1.The aged care facility managers did not pay enough attention to the physical restraint education and training of nursing staff,which is mainly reflected in the lack of systematic and comprehensive training,and the training content is single and scattered.Nursing staff are lack of awareness and knowledge of physical restraints,and skills need to be strengthened.The aged care facility managers should pay more attention to the education and training of physical restraints for nursing staff to standardize the use of physical restraints on the elderly and strengthen nurses’ concept of the use of alternative measures of constraints,so as to create an environment for minimizing constraints.2.The content of the evidence-based physical restraint education and training program for nursing staff in aged care facilities was scientific and comprehensive,and be highly recognized by experts.The construction of the program involved nursing staff,clinical experts,managers of aged care facilities and so on,which improved the scientificity and feasibility of the implementation of the program.The training program on physical restraints provided a reference for aged care facility managers to carry out physical restraint education and training for nursing staff.