The use of restrictive practices in the care of PLWD in hospital
Research type
Research Study
Full title
Understanding the everyday use of restrictive practices in the care of people living with dementia during a hospital admission: reducing inappropriate use, identifying good practice and alternative approaches to reduce risk and improve care
IRAS ID
313816
Contact name
Katie Featherstone
Contact email
Sponsor organisation
University of West London
Duration of Study in the UK
1 years, 3 months, 31 days
Research summary
This ethnography will examine everyday cultures of restrictive practices in the care of people living with dementia (PLWD) during an acute hospital admission in order to understand the nature, rationales, and experiences of PLWD, their families, and ward staff.
Ethnographic data collection will be carried out within 9 wards: 6 acute wards (3 x general medicine and 3 x older person’s care) and 3 specialist inpatient mental health wards (dementia specialist mental health in-patient wards across trusts in two regions of the UK (Yorkshire and the South East) and health boards in Wales. 30 days of observation will occur in each acute ward alongside 15 days of observation will occur in each mental health ward (n=225 days of observed practice).
Data collection will include
• Observing routine ward care practices within and across shifts (am/pm) and different staffing structures (weekends/nights), including handovers
• Shadowing the work of ward staff and wider hospital staff involved in the care of PLWD.
• Observing clinical assessments, team meetings, and where possible discharge and transfer meetings.
• Observing to identify which patients experience restrictive practices, what forms they take, and if there are any individual patients or groups who appear to be excluded, exempt, or experience increased use of these practices.
• Observing the care of PLWD perceived as at higher risk of adverse incident or ‘challenging’ behaviour.
• Ethnographic interviews (short <10 minute conversations during ethnographic observation) with ward staff
• Document analysis of ward records
• Interviews carried out with PLWD, their care partners and families to explore the recognition, understandings, and experiences of restrictive practices.
• Follow up interviews after discharge in the community with PLWD and their family members (n=>30) participating in the ward ethnography and interviews.
Analysis will inform the delivery of evidence-based strategies to support best practice in the care of PLWD at ward level, including open-access training and NHS service organisational interventions.REC name
London - Bromley Research Ethics Committee
REC reference
22/LO/0448
Date of REC Opinion
15 Jul 2022
REC opinion
Further Information Favourable Opinion