1751 – Does An Increase Of Staff Number Contribute To Changes In Physical Restraint Rates? a Longitudinal Measurement In a Geropsychiatry Unit

Abstract

Introduction

In Psychiatry there is a controversial discussion about the use of coercion in general. Against this background the question, by which factors physical restraint rates can be influenced is of foremost importance.

Objectives

In early 2008 we determined that those patients from the Geropsychiatry unit were most affected by physical restraints.

Aims

With the aim, to decrease physical restraint rates, a new concept of care was implemented in the Geropsychiatry unit. It included changes to staffing structure and staffing levels.

Methods

We performed a pre-post study (pre: 1st half of 2008, post I: 1st half of 2009, post II: 1st half of 2010, post III: 1st half of 2011). The evaluation focused on the criteria “staff number”, “physical restraint rates” and “fall rates”. The information value of the results is limited due to the used study design.

Results

There were no significant changes regarding the socio-demographic and performance data. The number of registered nurses (pre: 100%; post III: 122%) and assistant staff (pre: 100%; post III: 142) in real time increased by a total of 52 working hours per day on average. There were a significant decrease of the ratio of physically restrained patients (pre: 0.19; post III: 0.08; p < 0.0005), the total duration of restraint (pre: 3162 h; post III: 781 h; p < 0.0001), a reduction regarding further restraint criteria and insignificant changes in fall rates.

Conclusions

The results emphasize that changes to staffing levels can influence physical restraint rates. More and highquality research is needed.