Research on advanced physical restraint prevention activities conducted by nurses in general beds

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K17521
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Gerontological nursing
• Research Institution: Asahi University
• Principal Investigator: KIRIYAMA Keiichiro 朝日大学, 保健医療学部, 講師 (40790960)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 一般病床 / 身体拘束 / 身体拘束最小化 / 専門看護師 / 認定看護師

Outline of Final Research Achievements

This study consisted of two stages. Study 1 involved a fact-finding survey of physical restraints used in all general hospitals in four prefectures (Aichi, Gifu, Mie, and Shizuoka). As a result, 92.4% of the patients who were physically restrained in the general ward were judged by the nurses on when to start, temporarily release, or end the physical restraint. The average number of days of physical restraint was 22.9 days, with a minimum of 1 day and a maximum of 1198 days. In general wards, the frequency of conferences to end physical restraints was either daily or weekly.
Study 2 investigated physical restraint prevention activities performed by certified nurse specialists and certified nurses. As a result, specialist nurses were working with the medical safety department and practiced nursing while considering the patient’s life history and needs.

Free Research Field

精神看護

Academic Significance and Societal Importance of the Research Achievements

身体拘束について中立的な立場による複数県にまたがる全数調査は行われていなかった。本研究は一般病床の状況と身体拘束中の患者の状況を明らかにした。一般病床の身体拘束の概要を把握できたことで、今後の基礎資料となることが考えられる。また、診療報酬上、認知症ケア加算算定以降、チームの中核を担っていると考えられる老人看護専門看護師、精神看護専門看護師、認知症看護認定看護師の活動を明らかにした。身体拘束されている患者の多くは80最上の高齢者であった。高齢者を対象とする専門・認定看護師らは身体拘束最小化活動をリードする立場にある。その活動を明らかにすることも今後の身体拘束最小化活動に貢献できると考えられた。