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Vrijheidsbeperkingen in de thuiszorg: een inventarisatie onder verpleegkundigen en verzorgenden.

Veer, A.J.E. de, Francke, A.L., Kruif, A. de, Bolle, F. Vrijheidsbeperkingen in de thuiszorg: een inventarisatie onder verpleegkundigen en verzorgenden. Verpleegkunde: 2006, 21, 254-264
Physical restraints in home care. Nurses' experiences and opinions. Aim: this article describes what kind of interventions nurses view as physical restraints and the use of these interventions by nurses in the community. This is done to compare current practices with new proposals to regulate these interventions by law. Method: The questionnaires of 87 registered nurse (RNs) as well as 70 care workers (with two or three years' vocational training) working in home care organisations were analysed. Finding: Four out of every five nurses use physical restraint. The use of bed rails, locking the front door (to prevent the client to leave the house), limiting the freedom of movement (for example by putting the client in a deep chair), and forced application of tranquilizers or hidden administration of drugs were most often used. Most frequently mentioned reasons for these interventions are: protection of the client, on request of the client or on request of his representative. The final decision on intervening is most often taken by the representative of the client (e.g. a family member) or the nurse. Nurses indicate that only little attention is paid to supervising of the client. Nurses' opinions on whether certain measures are restraining freedom differ. A minority of the respondents indicate that they do not work with protocols, guidelines or written agreements on the use of physical restraints. Conclusion: Many nurses use physical restraints which underlines the necessity to regulate these kind of interventions by law. Also discrepancies between home care practice and the proposed formal physical restraint policy are found. (aut. ref.)