Objective: The aim of this study is to reduce the use of restraint in demented patients using a staff training program as intervention.
Design: The study is a randomized single-blind controlled trial and has taken place in a major city in Norway, Stavanger.
Materials and Methods: Single-blind controlled trial and has taken place in a major city in Norway, Stavanger. Four nursing homes were randomized to a control and an intervention group after stratification for size. N= 140 in each group. The intervention consisted of a full day seminar, followed by one session of guidance per month in six months. The content of the educational program focused on the decision making progress in the use of restraint and alternatives to restrain consistent with professional practice and quality care. The primary outcome measures were number of restraint per patient in the nursing homes in one week and behavior disturbance as measured with Brief Agitation Rating Scale (BARS). These were rated before and after the intervention was completed 6 months later, and were performed blind to design and randomization group.
Results: The outcome variables did not differ between the intervention and control groups at baseline. However, after completion of intervention, the number of restraints had declined with 54% in the treatment group, and increased with 18% in the control group. The difference between the two groups was statistically significant (U=1759,5, p=0.013). The BARS score did not differ between the intervention and control groups after intervention.
Conclusion: Although the level of agitated behavior remained unchanged, the educational program led to a significant reduction on the use of restraint in institutionalized elderly with dementia. These results suggest that educational programs can improve the quality of care of dementia.
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