[The prevalence of use of restraints in a Dutch teaching hospital. An exploration in two wards]

The use of restraints in The Netherlands has mainly been studied in psychiatric, geropsychiatric, elderly, and retarded persons. No study is known on this subject in Dutch general hospitals. The objective of our study was to determine the prevalence of the use of physical restraints and side-rails and factors associated with restraint and side-rail use in a Dutch teaching hospital. On two acute care wards (internal medicine and neurology) 208 consecutively admitted patients were personally observed for the use of side-rails in February 2001. The use of restraints was abstracted from the nursing records.

Of the patients 34% at least one time had side-rails raised, and 9% was subjected to physical restraints at some point during hospitalisation. In the logistic model, the neurology ward (OR: 4; 95% CI: 2-10), age of 80 or over (OR 12; 95% CI 3-51), stroke (OR 7; 95% CI 2-24), disorientation (OR: 9; 95% CI: 3-29) and restlessness or agitation (OR: 68; 95% CI: 7-596) were found to be independently associated with use of side-rails. For the use of restraints restlessness or agitation (OR: 125; 95% CI: 18-856) was found to be an independent factor. Differences in study design make comparisons between institutions and countries difficult.