Reducing restrictive practice in care homes by gamification

Queen’s University Belfast received funding from the Burdett Trust for Nursing to co-design a digital resource to aid decision-making that supports minimal use of restrictive practice in care homes. The digital intervention was co-developed using existing legislation, clinical guidelines and evidence relating to restrictive practice (e.g., Mental Capacity Act NI, 2016) alongside the experience of older people, family members/carers of older people, care home healthcare staff and other key stakeholders using co-design methodology. The e-resource can be accessed here: https://play.restrictivepractice.co.uk/

In a sample of 203 care home nurses, we saw improvements in knowledge and self-efficacy about how to use alternative strategies to restrictive practice. Before using the educational resource, the group of care home nurses had a mean score of 34/65 (52%). After completing the educational resource, the group of students had a mean score of 55/65 (85%), reflecting an increase in knowledge and self-efficacy score of 33%. When analysed using a paired-samples t-test, this increase from pre-test to post-test was statistically significant (p<0.001).

Following receipt of the e-resource about restrictive practice, we also asked care home managers to conduct an audit before and three months after learning to determine if the staff education had led to changes in practice. On post-test analysis, we determined that there were statistically significant reductions in the amount of restriction used across 15 nursing homes in Northern Ireland because of this learning (e.g., reductions in the use of lap belts and bed rails).