process of decision making in physical restraint cases in acute elder’s care

process of decision making in physical restraint cases in acute elder’s care

Introduction

This article is a review that intended to synthesize the qualitative evidence on decision making by nurses in physical restraint cases. Physical restraint use in acute healthcare facilities is every day in various countries. Decisions about physical restraint use are ethically laden. Practically, nurses make decisions that are morally informed. An ethical decision is the impact of complex reasoning strategy based on experience and knowledge and directed by ethical values. In acute elder care, use of the physical restraint needs a critical deliberation on various values at stake. Qualitative evidence about nurses’ decision making in different physical restraint cases provided essential insights into the complexity of making choices as a trajectory. However, refined and nuanced understanding of the reasoning procedure in ethical values still missing. Therefore, nurses experience ethical dilemma on how to make decisions effective concerning the issue.

Aim of the study

The research was carried out to provide a deeper understanding of the issues of decision making.  Making decisions by the nurses is categorized as ethical deliberation process where various values are recognized where the equalizing the values from the importance of moral deliberation.  The study, therefore, was carried to enable nurses to know about which values should be prioritized. The reason behind this it’s because of the issue of ethical dilemma which arises concerning the kind of the decision which nurse should make. Therefore, the main aim of the study was to explore the process of decision making in physical restraint cases in acute elder’s care.

Method

The research used a qualitative interview design to integrate different components of the study logically and coherently to address the problem effectively. The process of qualitative design was necessary for this study since it creates potential data which are useful to social scientists. However, the technique, to some extent, was not agreeable since it consumes a lot of time. Every project once initiated requires to stick to the time set. Therefore, the kind of method applied can be contradicting but had the chance of offering useful information.  Every process of collecting data got its weakness and strengths. What matters is the kind of research been conducted. It’s, therefore, the responsibility of the researcher to determine if the type of design they use suits the study.

All hospitals in Belgium with acute geriatric were contacted through emails, and theory four of the hospitals participated in the study. The information was collected through questionnaires which were distributed to the hospitals. The sampling was aimed to sample a variety of characteristics in hospitals like geographical location and religious afflictions.   Six of the hospitals used had the catholic affliction, and the other six hospitals didn’t have the spiritual afflictions. The questionnaires had closed-ended and open-ended questions.  The closed-ended questions focused on characteristics of the nurses while the open-minded questions focused on an ethical view about the physical restraint. The researcher presented the relevant samples used to collect the information needed. However, the examples used were not enough to gather enough information. It could be better if the research was conducted outside Belgium to compare ambiguous results to make an effective decision.

Data collection

The authors used the semi-structured in-depth interview to get information from interviewees on a different occasion when they decided physical restraint. The method of collecting data was a good one since it allows questions to be set earlier. This means that the questions asked to the participants had been established more first hence making the process of collecting information easier. Also, the use of open-ended questions indicated that the researchers wanted to receive data from different perspectives using one method of data collection. However, the technique might not have offered the best results since not all participants give complete information. The method requires the informer to stay focused. Not everyone would be interested in providing the correct information. The process also consumes a lot of time than what is needed. The kind of interview requires 30 minutes but based on this study; the interview lasted an hour.

Procedures

The data collection should be conducted ethically in every study. This means that there are some things which the researchers should adhere to make the research ethical enough. In this study, the data was collected ethically. The reason behind this its because the data was collected voluntary. Nobody was forced to engage in the interview and any sampling. Another evidence that the study was ethical is that data collection was made from different backgrounds. For example, six of the hospitals and the religious afflictions while the other six didn’t have afflictions. The research protocol was also approved by the ethics groups to ensure that there were no biases in the study taken. However, the authors didn’t consider the conflicts which could arise due to differences among the populations.

trustworthiness Enhancement

the researchers used various technique in their study it ensures trustworthiness. One of the tactics applied in the study includes audit trail development and developing the reports of the group meetings. The authors further uniquely discussed their assumptions by bracketing them. This means that they tried the best to ensure that they gained trust. It’s the responsibility of the researchers to demonstrate that data examination has been done in a consistent, precise and exhaustive manner to enable the reader to determine the reliability of the process. They could have discussed other issues related to dependability and confirmability. Confirmability implies that the researchers could have shown confidence level that findings are based on the participant’s words and narratives rather than potential biases by the researcher. The dependability could have been checked by looking if there are some mistakes in hypothesizing study, data collection and findings interpretation.

Results

The study conducted was compatible with the research tradition. Research tradition should define aspects like methods applied to collect data, how the issues were addressed to try to get a solution to the problem. Data analysis was conducted in the right way through illustrations, quotes to collect information from different groups. For example, the authors used tables 1 to 3, where each table had different categories of the people. The table had people with different experiences, various religious groups and different level of education. Quotes were received from different nurses who gave out their feedback concerning the issue of physical restraint. Such kind of quotes indicates that authors were determinant to fit enough information about decision making.  They gave different information, and some were not decided about the decision while others were not. The concept of making a decision is a dynamic and complex where answers vary from one person to another. Despite the interviews and ideas from the nurses, the authors were biased since they still believed that the concept of physical restraint is dynamic. They found an idea that decision making by nurses not constant and hence more studies could investigate the same.

Summary assessment

The study conducted was honesty based on various evidence given by the searchers in their research. Although the research didn’t have enough concepts to gain attention from the reader, the authors provided relevant and essential points. The study was conducted in a reliable manner such that the participants in data collection did that voluntarily. The results from the study were done accurately since various techniques erw used to gain enough information from the hospitals. The problem with the data collection it was collected from Belgium only. Its, therefore, the recommendation for such research to be conducted in various to gain enough evidence. Maybe other nations got different perspective which could have been included in the study and make results better.

Conclusion

The study conducted was done ethically since authors followed most of the steps required. The study aimed to investigate decision making by users concerning the physical restaurant in acute elder care. Such kind of problem is complex and might need complex research as well. The authors collected information from different fields. However, the issue seemed complicated, and even nurses themselves gave different concepts about the subject. Therefore, still, nurses remain in an ethical dilemma concerning the idea of decision making in this study since the authors didn’t give out the final decision.