Paper
Friday, July 23, 2004
Outcomes of Physical Restraint Use and RN Staffing in Hospitalized Hip Fracture Patients
Eileen Sullivan-Marx, PhD, RN, FAAN, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA, G. Maislin, MS, Biomedical Statistical Consulting, Wynnewood, Pennsylvania, USA, and Jeffrey Carson, MD, Department of Medicine, University of Medicine & Dentistry New Jersey, New Brunswick, NJ, USA.
| Learning Objective #1: Gain an understanding of factors related to the association of work environment, staffing, and physical restraint use in older adults |
| Learning Objective #2: Gain an understanding of quality of care indicators that are nurse sensitive with elderly hip fracture patients |
Purpose: This study examined the effects of hospital staffing (RN-patient ratios and staff mix) on physical restraint by year of policy enactment and type of hospital. Design: A retrospective case cohort design in 20 urban teaching hospitals in four regions of the U.S. from 1983-1993. Sample: Mean age of subjects was 82.6, 80% were women, and 87.4% were white, 22.3% were admitted from nursing homes, and 62.6% were independent in activities of daily living prior to hip fracture. Rate of restraint use for hospitalized hip fracture patients was 31.5% for all years. Procedure: Data on nurse staffing were obtained from the American Hospital Association Annual Hospital Survey. Patient data were obtained from a large parent clinical data set of hip fracture patients in 20 hospitals. Analysis: A mixed model was used to control for nesting of variables and examine relationships and outcomes. Findings: Hospital RN to patient ratios had an effect on reducing mortality and physical restraint use controlling for patient factors. Variations in outcomes by hospital type and year of national hospital policy on restraint use will be presented.
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Sigma Theta Tau International
July 22-24, 2004