- 期刊
長期照護機構中的身體約束議題
Physical Restraint Use in Long-term Care Facilities
摘要
長期照護機構住民的身體約束，經常使用在維護住民安全的照護措施。在國外不斷倡導「無約束照護環境」的理念下，我國長期照護機構身體約束盛行率仍然居高不下，最常使用的約束理由為：預防跌倒、預防自拔留置管路、行為紛亂躁動及維持肢體正常功能位置等。為了維護住民的照護品質，降低不必要的約束，老人福利機構評鑑對約束的規範均作明確的規定，機構必須定期作約束指標的監測，以維護住民身體約束的安全。約束作業流程是工作人員正確評估住民約束需求及照護評值的依據，而執行約束前的「替代措施」，更是降低住民身體約束的重要措施。本文主要依據長期照護機構身體約束的現況，依照正確約束流程規範說明評估及照護內容，並整理臨床可使用的約束替代措施提供機構參考。
並列摘要
Physical restraints are often applied methods of care for the reasons of preserving safety and preventing accidences for residents in long-term care (LTC) facilities. Although nowadays the concept ”restraint-free care” is well popularized in advanced countries, the prevalence of physical restraints in LTC facilities is still high in Taiwan. The most common reasons for restraint are preventing residents from falls and removing indwelling tube, avoiding restless action and confusion, as well as keeping bodies' function and position normal...etc. In order to preserve quality of care and to reduce unnecessary restraints, there have been definite stipulations about restraints for the residents in the LTC facility accreditation. The accreditation indicators include the facilities must monitor norms for restraint regularly to preserve safety of residents and the staffs have to estimate residents' need of restraint in accordance with standard of restraints procedures. Hence, making standard of restraints procedures is essential for LTC facilities. Before restraints are performed, ”alternative methods to use” is one of the most essential and important measures to reduce facts of restraints for residents. Based on the clinical experiences in the nursing home, the paper introduces and explains how to care under correct standards of restraints procedures, and also provides useful clinical alternative methods of restraint in order to give LTC facilities practical suggestions.