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Use of constraints and surveillance in Norwegian wards for the elderly
Øyvind Kirkevold1, Knut Laake, Knut Engedal
1Norwegian Centre for Dementia Research, Vestfold Mental Health Care Trust, Tønsberg, Norway. oyvind.kirkevold@nordemens.no
Objective:
To describe the use of constraints and surveillance and their correlates in a nationwide sample of wards in institutions for the elderly in Norway.
Methods:
Questionnaires were sent to 975 institutions and returned by 623 (64%) with 1398 wards. The wards' head nurses were asked whether any patient was currently subjected to physical restraints, electronic surveillance, force or pressure in medical examination or treatment, and force or pressure in ADL. The reporting of constraints was found reliable.
Results:
In all, 79% of the head nurses reported daily or occasional use of constraints in their wards. Most frequently reported were force or pressure in the performing of activities of daily living (reported by 61%, 95% Confidence Intervals (CI) 59-64), use of force or pressure in medical treatment or examination (49%, 95% CI 47-53) and use of physical restraints (38%, 95% CI 36-41). Electronic surveillance was used less frequently (14%, 95% CI 13-16). All classes of constraints, except physical constraints, were used significantly more frequently in special care units for persons with dementia than in ordinary nursing home units. The methodology does not allow conclusions to be drawn regarding the role of ward size and person characteristics. The staffing was unrelated to the use of constraints which varied significantly across the counties.
Conclusion:
Constraints are widely used in Norwegian institutions for the elderly. A different pattern in use of constraints was found between special care units for demented patients and ordinary units in nursing homes.