[Use of physical restraints in an elderly population living in public nursing homes]. / Uso de sujeciones físicas en una población anciana ingresada en residencias públicas.

OBJECTIVE: To determine the prevalence of the use of physical restraints in public nursing homes through the Residents' Functional Classification Information System in order to assess the introduction of a protocol designed to reduce and rationalize the use of these devices. MATERIAL AND METHODS: Twenty-five public nursing homes in the autonomous region of Madrid were included in this study. The following data on the use of physical restraints were analysed: frequency of use (daily or less than daily), type of device, level of functional dependence for activities of daily living, and severity of cognitive impairment. RESULTS: A total of 5346 residents were included. The prevalence of the use of restraints was 8.4%. When the use of bedrails was added, this percentage rose to 20.8%. Bedrails accounted for 63.4% of all restraints used, trunk restraints for 17.7%, limb restraints for 3%, and chairs preventing voluntary rising for 15.9%. A single device was used in 62.6%. Of the restraints, 71.4% were used daily and 28.6% were used temporarily. CONCLUSIONS: The results of this study represent an approximation to the current use of physical restraints in nursing homes. The prevalence found was similar to, or less than, that observed in previous studies. The most commonly used form of restraint was bedrails. The use of these devices is probably excessive, affecting even residents without cognitive impairment or physical dependence. To reduce the use of restraints and guarantee optimal care when their application is indicated, the Regional Social Welfare Service systematically applies a protocol for the prevention and use of physical restraints.

Uso de sujeciones físicas en una población anciana ingresada en residencias públicas / Use of physical restraints in an elderly population living in public nursing homes

Objetivo: conocer la prevalencia de uso de dispositivos de sujeción física en residencias públicas de mayores utilizando el Sistema de Información Clasificación Funcional de Residentes, para evaluar la implantación del protocolo dirigido a reducir su uso y asu manejo racional.Material y métodos: se han incluido en este estudio las 25 residencias públicas de la Comunidad de Madrid. Se analizan datos sobre el uso de sujeciones físicas: frecuencia de su uso (diario o no), tipo de dispositivo, grado de dependencia funcional para las actividades de la vida diaria (AVD) y el grado de deterioro cognitivo. Resultados: residentes incluidos: 5.346. La prevalencia fue del 8,4%. Añadiendo el uso de barandillas en la cama, el porcentaje se eleva al 20,8%. El 63,4% de las sujeciones eran barandillas; había restricción de tronco en el 17,7%, restricción de miembros en el 3% y sillas de sujeción en el 15,9%. Sólo se utilizó un dispositivoen el 62,6%. De las sujeciones, el 71,4% se utilizó a diario y 28,6% de forma no permanente.Conclusiones: los resultados permiten obtener una aproximación a la situación actual del uso de sujeciones físicas en residencias. La prevalencia es similar a la obtenida en otros estudios e incluso inferior a otras publicadas. Las barandillas son el dispositivo de sujeción más empleado. Probablemente exista un uso excesivo de barandillas que afecta incluso a residentes sin deterioro cognitivo ni dependencia física.Para reducir su utilización y garantizar los mejores cuidados en aquellos casos en los que estén indicadas, el Servicio Regional de Bienestar Social está aplicando de forma sistemática un protocolo de prevención y uso de sujeciones mecánicas

Objective: to determine the prevalence of the use of physical restraints in public nursing homes through the Residents’ Functional Classification Information System in order to assess the introduction of a protocol designed to reduce and rationalize the use of these devices.Material and methods: twenty-five public nursing homes in the autonomous region of Madrid were included in this study. The following data on the use of physical restraints were analysed: frequency of use (daily or less than daily), type of device, level offunctional dependence for activities of daily living, and severity of cognitive impairment.Results: a total of 5346 residents were included. The prevalence of the use of restraints was 8.4%. When the use of bedrails was added, this percentage rose to 20.8%. Bedrails accounted for 63.4% of all restraints used, trunk restraints for 17.7%, limb restraints for 3%, and chairs preventing voluntary rising for15.9%. A single device was used in 62.6%. Of the restraints, 71.4% were used daily and 28.6% were used temporarily.Conclusions: the results of this study represent an approximation to the current use of physical restraints in nursing homes. The prevalence found was similar to, or less than, that observed in previous studies.The most commonly used form of restraint was bedrails. The use of these devices is probably excessive, affecting even residents without cognitive impairment or physical dependence. To reduce the use of restraints and guarantee optimal care when their applicationis indicated, the Regional Social Welfare Service systematically applies a protocol for the prevention and use of physical restraints