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Novel Approaches Needed: An Experimental Study with an Alternative to Mechanical Restraint
Tilman Steinert1, Bernd Maierhofer2, Peter Schmid2
1Klinik für Psychiatrie und Psychotherapie I, Ulm University (Weissenau), Weingartshofer Str. 2, 88214 Ravensburg, Germany.
Healthcare (Basel, Switzerland)
|August 29, 2024
Summary
This study introduces a novel, less humiliating alternative to mechanical restraint using weighted fitness bags. Patient and nurse feedback suggests it
Area of Science:
- Psychiatry
- Nursing
- Patient Safety
Background:
- Mechanical restraint is widely used despite calls for reduction, causing patient humiliation.
- A lack of humane alternatives exists for managing acutely violent patients when de-escalation fails.
Purpose of the Study:
- To evaluate a novel intervention using weighted fitness bags as a less restrictive alternative to mechanical restraint.
- To assess patient and healthcare professional perceptions of this new method.
Main Methods:
- A method using 30 kg fitness bags attached to limbs under 1:1 supervision was developed.
- The intervention was tested by 10 nurses; a video was shown to 6 former patients.
- Qualitative content analysis of interviews with all participants informed the findings.
Main Results:
- All participants viewed the fitness bag method as a milder, less humiliating alternative to mechanical restraint.
- Nurses raised concerns regarding fall risks and potential misuse of bags as weapons, which could be mitigated.
- Patients, particularly those with a history of abuse, responded positively to the intervention.
Conclusions:
- The fitness bag method shows promise as a replacement for some mechanical restraints.
- Further development is needed, ensuring this 'milder means' does not introduce new forms of coercion.
