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Date: February 25, 2004 (Wednesday)
Time: 12:30 to 14:00 (Light lunch at 12:30, Seminar begins at 12:45)
Venue: Seminar Room 5, LG/F, Laboratory Block, Faculty of Medicine
Building, 21 Sassoon Road, Pokfulam
In the late 1980s in the United States,
research suggesting that physical restraints were ineffective or
hazardous helped to shift policy and practice toward restraint-free
care in nursing homes. Standards of practice to limit restraint
use in hospitals, however, have remained inconsistent. Although
several national accreditation bodies and Federal agencies warn
against unnecessary restraint use in hospitals, considerable variability
in practice exists across hospitals and health systems. Care of
patients who are cognitively impaired or considered at risk of removing
treatment devices in critical care units, for example, remains a
stronghold for use of physical restraints. This talk reports the
findings from two large clinical studies in restraint reduction
funded by the United States National Institutes of Health. The aims
of the studies were to implement an advanced practice nurse directed
restraint reduction intervention first for nursing home residents
and then for nursing home residents during hospitalization for acute
illness. During the conduct of the second study, enormous changes
were taking place in hospital organization and the nursing workforce.
These changes had significant impact on outcomes of the study. The
study findings did support restraint reduction for hospitalized
elders. The conduct of the study itself, however, pointed out equally
important limitations in delivering quality care in a context of
hospital restructuring and without adequate numbers of professional
nurses knowledgeable about geriatric care. These lessons are critical
to understanding the state of the science and future investigations
in the U.S. and in other economically developed countries.
Bio-sketch:
Dr Strumpf is widely recognized
for her outstanding contributions to the field of gerontology. Although
Dr Strumpf is probably best known for her work with her colleague,
Dr Lois Evans, on the elimination of physical restraints in nursing
homes and hospitals, her remarkable career as ground-breaking researcher,
innovative teacher, caring mentor, as well as top administrator,
is unmatched. Dr Strumpf's long, distinguished record of honors
includes the prestigious Lindback Teaching Award and her tenure
as Interim Dean of the School of Nursing. Currently she is Director
of the Center for Gerontologic Nursing Science and the Hartford
Center of Geriatric Nursing Excellence, where she continues to develop
new models of care that enhance the quality of life for frail elders.
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