SINGAPORE – A move by Khoo Teck Puat Hospital (KTPH) to improve the quality of care for elderly patients has hit a milestone, with all five of its geriatric wards marking one full year without using physical restraints in August.<\/p>\n
These include body vests, as well as arm and leg restraints, which are used to prevent patients from harming themselves or others, stop them from removing medical devices such as catheters, and to protect them from falls.<\/p>\n
The move to go restraint-free has shown results, with patients showing greater physical mobility and an 82 per cent reduction in refusal of care, noted KTPH, a hospital under the NHG Health public healthcare cluster.<\/p>\n
\u201cPatients also demonstrated higher levels of interaction and decreased agitation,\u201d the hospital said in a statement on Dec 9.<\/p>\n
Hospital staff, meanwhile, showed greater empathy for patients and a 20 per cent decrease in self-reported burnout, it added.<\/p>\n
KTPH first began avoiding the use of restraints with the establishment of its Care for the Acute Mentally Infirm Elder ward for patients with dementia in 2012. Extending this approach to all of its geriatric wards, which comprise some 160 beds, marks a significant expansion of this initiative.<\/p>\n
Geriatric wards are typically for patients with diseases that affect seniors specifically, such as dementia.<\/p>\n
KTPH senior consultant geriatrician Philip Yap said that frail seniors make up more than half of the patients at the hospital.<\/p>\n
Of those in the geriatric wards, up to three-quarters have cognitive impairment in the form of dementia or delirium, and many also struggle with depression and agitation, which leads to them not cooperating with healthcare workers and refusing care, he noted.<\/p>\n
The task-oriented nature of work at the hospital means staff are often unable to take the time to get to know patients and their preferences, he added.<\/p>\n
While restraints may ensure the physical safety of such patients, they can also make patients more aggressive and less likely to accept care, he said.<\/p>\n
To ensure KTPH staff know how to care for elderly patients with complex needs, more than 500 employees, primarily nurses, were trained in Humanitude \u2013 a care methodology that aims to improve the quality of life for those with dementia by focusing on respect, empathy and connection.<\/p>\n
Rather than using restraints, the hospital found other solutions.<\/p>\n
These included the use of pressure-sensing mats which send out alerts when patients try to get out of their beds.<\/p>\n