Physical Restraints for Dementia Patient-Free-Samples for Students

Question: Develop a research proposal based on either a Quantitative or Qualitative Methodology. Answer: Research Proposal-Qualitative Title Understanding the use of physical restraints for dementia patient in acute care setting from the perspectives of the nurses Purpose of the study and aims The proposed study will have the following objectives: To assess the use of physical restraints in case of dementia patients in acute care setting To detect and evaluate the association of physical restraints in dementia patients with the length of stay in acute care setting within hospitals To detect the prevalence and circumstances pertinent to the use of physical restraints for dementia patients admitted in acute care setting in hospitals To understand the potential complications and challenges encountered by nurses related to the use of physical restraints for the dementia patients admitted in acute care setting The projected study will have aims as follows: To give a succinct overview and pertinent knowledge about the potential uses of physical restraints for the dementia patients admitted in acute care setting To detect the merits and limitations of using physical restraints for dementia patients To indicate the possible relevance and the situations specific to the use of physical restraints in case of dementia patients admitted in acute care setting in hospitals To highlight the benefits and implications of using physical restraints for dementia patients and the possible relationship with the duration of stay in hospital Background and preliminary literature The use of physical restraints has gained prominence in acute care settings in hospitals for tackling the patients in effective manner. Relevant literatures have shown that the elderly individuals suffering from memory disturbances are the ones most likely to be put on physical restraints. Prevention of falls and combat of the behavioral responses such as that of being confused or being violent are the primary reasons for such utilization of physical restraints (Ang et al. 2015). Other pertinent studies also documented the rampant use of restraints in the geriatric care setting while in clinical practice by the nurses. The favorable decisions of nurses regarding use of physical restraints while in doubt and despite the presence of enough evidence about their potential benefits has been confirmed in such studies (Mhler and Meyer 2014). In other instances, alternatives to physical restraints for optimizing the patient safety have been presented and the expertise of the physical therapi sts has been solicited in this respect to enhance patient safety, functional independence and mobility. However, the declining rate of usage of physical restraints has also been mentioned simultaneously (Cleary and Prescott 2015). Moreover, dementia has been identified as a predisposing risk factor for incident delirium. Therefore, in such cases enough knowledge about the risk factors and early detection of the threats to delirium might pave way for effective strategies meant for improving patient safety and mitigating potential harm (Tomlinson et al. 2016). Further, introspections carried out with respect to the use of physical restraints have put valuable insights on interventions that might act to prevent and reduce the use of physical restraints for older people in general hospital settings (Mhler et al. 2016). The negative outcomes of use of physical restraints has been indicated in other study where older patients put on physical restraints and receiving anti psychotic medicat ions are found to be more vulnerable of getting affected by both functional as well as cognitive decline (Foebel et al. 2016). Another study has highlighted that physical restraint is more risky compared to antipsychotic drug for diminishing the physical and cognitive functioning in older home care residents (Graziano Onder et al. 2016). For patients admitted to residential care setting, the use of physical restraints has been found to accentuate the risk of development of psychotic symptoms coupled with benzodiazepine use. On the contrary, the use of antipsychotic antidepressant medication alongside practice of good activities of daily living (ADL) reduced the risk of restraint use (Kuronen et al. 2016). Thus, it is imperative to pay adequate attention to the uses of physical restraints for better understanding the potential advantages and disadvantages associated with their uses in patients suffering from dementia and admitted to acute care setting. Subjects-Inclusion and Exclusion criteria Nurses will be chosen as potential candidates for the study. Participants for the potential study will be recruited from the hospitals in Singapore. The inclusion criteria for such participation will be as follows: Nursing professionals who are engaged in working at the acute care facilities in hospitals of Singapore and are entrusted to take care of the dementia patients. Registered Nurses who have a minimum working experience of at least two years and are adept in tackling dementia patients in acute care setting will be specifically selected. The exclusion criteria for the study participants will be as follows: Nurses who work in other facilities other than the acute care setting and are not acquainted in dealing with dementia patients will not be recruited in the study. Nursing Aid/Nursing Assistant and Certified Nursing Assistant (CNA) will be exempted from participating in the study due to lack of experience and enough professional competencies. Study plan and design The prospective study will make use of the observational study design besides the potential application of the descriptive research design to gain deeper insight and relevant understanding about the chosen topic of research. The identification of the aims and objectives related to the research will enable the researcher to make use of these research approaches (Salazar, Crosby and DiClemente 2015). As part of the observational study, elderly (above age of 60 years) dementia patients admitted to the acute care setting in hospitals at Singapore will be noted for their behaviors and other health related information for the sake of monitoring the uses of physical restraints at the time of hospitalization. The medical records of the concerned patient will be tracked down within the given timeframe to gain proper knowledge and insight about the topic of research (Creswell and Poth 2017). Further, as part of the descriptive research design, open ended questionnaire will be framed for conduc ting the interview session with the nurses directed to derive information about the potential challenges or benefits depending upon circumstances to ensure safety to the dementia patients. Further, for the interpretation of the data obtained, rigorous statistical operations will be employed. Non-parametric tests like that of the Chi Square test will be performed to explore the effect of single variable on the use of physical restraints (Jackson 2015). Regression analysis will further allow for computation and concomitant estimation of the relationships among the patient related variables and the use of physical restraints. Outcomes The outcome variables that will be investigated in course of the study will address the issue of the use of physical restraints for the dementia patients admitted in acute care setting in hospitals. The length of stay in the hospital for such patients will be assessed for understanding of the potential association with respect to the use of physical restraints. The challenges and benefits as stated by the nurses will be taken into consideration for evaluating the uses of physical restraints. Thus, the outcome variables will be chosen in a prudent and pragmatic manner to provide succinct information about the chosen topic of research. Ethical considerations The study will be undertaken by considering the ethical aspects of research. Prior to the commencement of study, necessary consent and approval will be sought from the concerned authority to carry out the work in a legally and ethically competent fashion. The information acquisition of the relevant patient will be done by means of hospital records. The study will not involve direct participation of patients as subjects of research (Flick 2014). However, information relevant to them will be collected from the records of the hospital. Therefore, before approaching with the research necessary approval will be sought from the hospital authority to allow for safe handling of data. Further, for gaining access to information about the potential challenges and issues faced by the professional nurses in using physical restraints for the dementia patients, open ended questionnaire will be framed for deriving information by virtue of conducting interview sessions with them. Consent will be soug ht from these nursing personnel working in acute care facility to retrieve data pertaining to the topic of research, the purpose will be made clear to them beforehand to increase the reliability, and validity of the research that will be performed (Bell 2014). The ethical clearance sought from the appropriate governing body will ensure that the study is conducted abiding by the requisite procedure and appropriate methods. Drugs The study will not make use of any drugs in course of collection of data. Moreover, no drug related information or pharmacologic effects of specific drugs shall be indicated in the study that might suggest the possible uses of the concerned drugs in the given context. The physical restraints applied in case of dementia patients in acute care setting do not conform to the use of drugs and hence will be purposely excluded from being mentioned in the study. Specific safety considerations The conduct of the study will be completed with utmost safety and care to minimize the chances of occurrence of errors whatsoever. The data retrieved from the appropriate sources will be kept in the safe custody of the principal investigator with secured password set in the laptop. No one other than the principal investigator and the research associates will have access to data. Data collected from patients records will be held as anonymous and precautions will be taken beforehand to ensure that no data is leaked under any circumstances. Thu confidentiality of the data will be prioritized (Ritchie et al. 2013). The safekeeping and deft handling of data will thereby enhance the credibility of the research that will further add value to the study that will be undertaken to provide an insight on the chosen topic of study. The entire study will be carried out in abidance with the Data Protection Act, 1998 (Council 2016). Analysis and reporting of results On completion of the data collection stage, effort will be taken to properly analyze the data for gaining meaningful information out of the retrieved data. Analysis of the patient characteristics through performance of interview of the nurses will be done by virtue of the multi-dimensional dementia assessment (MDDA) scale. It will aid in understanding the behavioral and psychological symptoms of dementia in relation to the use of physical restraints in those patients (Dourado et al. 2014). The subsequent steps in analysis will resort to the statistical calculations through conduct of the non-parametric tests and regression analysis to gather pertinent and appropriate results out of the data collected. Thus, the reporting of results will be carried out in a manner that is in firm alliance with the scientific approach and accepted statistical procedure. Relevant information The study will depict no potential conflict of interest on the part of the researcher in terms of exhibiting compromise being made with respect to financial considerations or in pursuing professional commitments. However, the dearth of sample in collecting information relevant to the procurement of relevant information regarding the use of physical restraints for dementia patients admitted in acute care hospitals might pose limitations to the study. The statistical interpretation of data must be carried out with utmost care to arrive at meaningful conclusion from the data collected through information procured from the hospital record and interviewing the nurses on matter related to the topic of research in due course following definite strategies in compliance to specific safety considerations and ethical approval from the designated authorities. Date of proposed commencement The proposed study will commence from 1st August 2017 and the study ending deadline will be fixed as 31st December 2017 thus, setting the duration of the study to be of total 5 months. Efforts will be made to ensure that the proposed study will be completed within the set timeframe without any delay. Resource considerations Proper budget and a stipulated timeframe for the proposed study will be required to ensure the satisfactory conduct of the proposed study. The time limit of the study will be set no longer than 6 months for ease of data collection and retrieval of suitable information in connection with the study. Budgetary support will be sought from appropriate authorities for smooth undertaking of the study operations. ng of definite research questions, performing extensive literature review, outlining definite methodology appropriate for the study and providing insights regarding the proper collection and analysis of data. References Ang, S.Y., Bakar Aloweni, F.A., Perera, K., Wee, S.L., Manickam, A., Lee, J.H.M., Haridas, D., Shamsudin, H.F. and Chan, J.K., 2015. Physical restraints among the elderly in the acute care setting: Prevalence, complications and its association with patients characteristics.Proceedings of Singapore Healthcare,24(3), pp.137-143. Bell, J., 2014.Doing Your Research Project: A guide for first-time researchers. McGraw-Hill Education (UK). Cleary, K.K. and Prescott, K., 2015. 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