Physical restraints in home care in the Netherlands

Four out of every five nursing staff members in Dutch home care have applied physical restraints. Guidelines are necessary regarding what to do when a client is in danger of hurting him- or herself, researchers of NIVEL state in The Journal of the American Geriatrics Society.

The use of bed rails, putting the client in a deep chair or using a chair with a table, and locking doors to prevent wandering were most frequently applied, often at the request of the client of his or her family. Protection of the client is the reason most frequently given for these actions. 94% of nurses know of no alternatives, nor does consensus exist on what is to be considered to be a physical restraint.

NIVEL-researcher Anke de Veer: “The application of physical restraints is not allowed in home care. Many nurses are confronted with a dilemma how to react on such requests or when a client is supposed to be in danger. They should be supported in their decision making and educated on the dangers of physical restraints and the possible alternatives. Guidelines are necessary regarding the course of action to be taken when a client is in danger of hurting him- or herself.”

For the survey one hundred fifty-seven nursing staff in home care from a randomly selected and nationally representative panel returned a structured questionnaire on the use of physical restraints (response rate 72%).