Authors: (including presenting author): :
Cho HL(1), TSAI KL(1)
Affiliation: :
(1) Occupational Therapy Department, Haven of Hope Hospital
Keyword 2: :
Physical restraint
Keyword 3: :
Restraint reduction
Introduction: :
Restraint Reduction Program was inaugurated in HHH since2023. By emphasizing both safe reduction of restraint and preservation of patients’ hand function, Occupational Therapy (OT) targets to develop an innovative alternative hand mitten, the Trumpet Hand Mitten (THM). It comes with a spacious trumpet-shaped design to preserve mobility of finger joints and a broad tip opening for facilitating observation of patients’ hands. During the pilot implementation, the application, efficacy and phenomena were meticulously observed and investigated.
Objectives: :
To preserve hand function and enhance the observability of patients’ hands through an innovative THM as a strategy of restraint reduction.
Methodology: :
OT initiated the in-house design of the prototype of THM with reference to FYKH in 3Q 2023. After passing the preliminary test, THM version 1.0 was produced for the first clinical trial in 1Q 2024.
Based on the consolidated experience and high-temperature disinfection formula test in 2Q 2024, THM version 2.0 was refined for the pilot implementation in 4Q 2024, culminating in the completion of data collection from 1 November 2024 to 31 October 2025.
Result & Outcome: :
THM was implemented across 6 medical wards, encompassing a total of 48 patients during the pilot phase. The 6 major reasons of wearing THM are NG-tube (64.6%), Drip-site(18.8%), Foley (10.4%), Agitation (6.3%) and Scratching and Nasal cannal (4.2%). 56.3% of patients utilized THM throughout their hospital stay, which ranged from over 10 to 90 days. 54.2% of patients applied THM by both hand, while 27.1% utilized by left hand and 18.8% worn by right hand solely due to their hemiplegic condition. Thus, to preserve the unaffected hand function from physical restraint is imperative. Most of the patients (66.7%) tolerated THM without self-detaching , while only 3 single cases had detached THM for 4 times or more. The most encouraging findings indicated 54.2% of patients could fade out limb holder restraint after wearing THM, as well as 14.6% of patients could fade out THM safely before discharge. Since THM induced zero drawback, 43.8% of patients were willing to use THM after discharge. The favorable outcomes substantiated the efficacy of THM within a restraint reduction program.
