Developing a Comprehensive Care Protocol for Physical Restraint Optimization among Elderly Patients in Acute Care Hospitals

Research Project

Project/Area Number	17K12423
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Gerontological nursing
Research Institution	Juntendo University
Principal Investigator	SUGIYAMA Tomoko 順天堂大学, 医療看護学部, 准教授 (90459032)
Project Period (FY)	2017-04-01 – 2021-03-31
Project Status	Completed (Fiscal Year 2020)
Budget Amount *help	¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000) Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000) Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000) Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Keywords	看護学 / 高齢者 / 急性期病院 / 身体拘束 / 家族 / 看護師 / 認知障害
Outline of Final Research Achievements	This study aimed to develop a comprehensive care protocol that aims to reduce physical restraint among the elderly in acute care hospitals and their families. A questionnaire survey was conducted regarding the actual state of care during physical restraint implementation for 2000 nurses in general wards nationwide. Additionally, an interview survey was conducted with 19 nurses regarding the care methods for the elderly and their families for the proper implementation of physical restraint. The results revealed that about 90% of the respondents are making efforts to reduce physical restraint, and that cooperation from doctors and nursing department policies had an impact on reduction of physical restraint. Further, it was suggested that it is important for staff members to evaluate the causes and meaning of pain and behaviors among the elderly, offer concrete explanations to families, cooperate and collaborate with multiple occupations, and offer care to reduce physical restraint.
Academic Significance and Societal Importance of the Research Achievements	本研究の学術的意義は、急性期病院の高齢患者への身体拘束低減に向けた取り組みにおいて、これまで行われている管理的・倫理的観点からのアプローチだけではなく、身体拘束に代わる具体的なケア内容やこれまで注目されていなかった家族へのケアの必要性を明示したことである。特に家族から身体拘束を希望する場合も多い現状があり、これは、看護師の身体拘束の低減に向けた取り組みの弊害にもなり得ることが明らかになった。また、高齢者、家族それぞれの立場から考える身体拘束の低減に向けたケアの実施やケアを継続するための方向性を示したことは、高齢者へのケアの質向上に貢献するものである。