• Guenna Holmgren Amina A Department of Learning, Informatics, Management and Ethics (LIME), Stockholm Centre for Healthcare Ethics (CHE), Karolinska Institutet, Stockholm,, Niklas Juth, Anna Lindblad, and Ann-Christin von Vogelsang.
• Department of Learning, Informatics, Management and Ethics (LIME), Stockholm Centre for Healthcare Ethics (CHE), Karolinska Institutet, Stockholm, Sweden; Neuro Theme, Karolinska University Hospital, Stockholm, Sweden. Electronic address: amina.guenna.holmgren@ki.se.
• World Neurosurg. 2020 Jan 1; 133: 104-111.

ObjectiveTo investigate the extent to which restraint is used in neurosurgical care, under what circumstances, and how it is documented.MethodsA cross-sectional study with a mixed-methods approach was used to identify neurosurgical inpatients subjected to restraint. The data were collected in 2 phases: (1) a study-specific questionnaire was distributed to nurses in which they identified if restraints had occurred during their shifts, and if so, which restraint and to which patient; and (2) scrutinizing of electronic medical records of patients identified by the questionnaires. Numeric data were analyzed using descriptive and analytic statistical methods, and textual data were analyzed using qualitative content analysis. The findings from the different data sources were compared and merged.ResultsOf the 517 patients admitted to the studied department during the study period, 58 (11%) were reported to have been subjected to restraint and most of the restraining events occurred in the neurointensive care unit. Most restraint measures were not documented in the electronic medical records. The identified patients were predominantly diagnosed with traumatic brain injury or subarachnoid hemorrhage. The qualitative content analysis showed the circumstances when restraints were used: when patients were considered a danger to self or others (theme) and which symptoms and behaviors (categories) were observed in relation to the use of restraint.ConclusionsRestraint in neurosurgical care is mostly used to prevent patients from harming themselves or others. Because of the lack of documentation, restraint measures cannot be openly assessed, thus putting patients' safety at risk.Copyright © 2019 Elsevier Inc. All rights reserved.

20 keywords...

hide…