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Reduction of Belt Restraint Use: Long-Term Effects of the EXBELT Intervention.
MedLine Citation:
PMID:  23301773     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To assess the long-term effects of the EXBELT intervention program, which was designed to reduce belt restraint use and was found to be effective immediately after implementation, after 24 months. DESIGN: Quasi-experimental longitudinal design. SETTING: Thirteen nursing homes: seven assigned to control group and six to intervention group. PARTICIPANTS: A panel group (n = 225) of residents present at baseline and 24 months after baseline and a survey group (n = 689) of all residents present 24 months after baseline. The survey group included the panel group. INTERVENTION: EXBELT included four components: a policy change, an educational program, consultation, and availability of alternative interventions. MEASUREMENTS: The use of belt restraints 24 months after baseline was the primary outcome measure. Secondary outcomes included other types of physical restraints. An independent observer collected data four times during a 24-hour period. RESULTS: EXBELT resulted in a 65% decrease in belt use between baseline and 24 months after baseline in the panel group (odds ratio 0.35, 95% confidence interval = 0.13-0.93; P = .04). In the survey group, the proportion of residents using belts was 13% in the control and 3% in the intervention group (P < .001) 24 months after baseline. The use of the most restrictive types of restraints was significantly lower in the intervention group than the control group in the panel and survey groups. CONCLUSION: The EXBELT intervention was associated with long-term minimization of belt restraint usage in older nursing home residents. A multicomponent intervention including institutional policy change, education, consultation, and the availability of alternative interventions had an enduring effect on successful restraint reduction.
Authors:
Math J M Gulpers; Michel H C Bleijlevens; Ton Ambergen; Elizabeth Capezuti; Erik van Rossum; Jan P H Hamers
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  -     ISSN:  1532-5415     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
Affiliation:
Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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