Analyse de la pratique de la contention et du rôle du médecin traitant dans deux EHPAD de la région bordelaise en juin 2018

Abstract : Introduction: the best practices recommendation of the ANAES 2000: « to limit the risks involved in passive physical restraint for older people » asks us to issue a prescription valid for 24 hours only, then to reassess the practice of physical restraint and renew it if the physician deems it necessary. The objective of this thesis is to know if caregivers are able to respect the recommendation and rôle of the general physicians. Material and method: qualitative research carried out in EHPAD includes a survey of physical restraint of the patients and of a semi-directive interviews of caregivers. Results: 123 patients were considered, 34 of whom had required past physical restraint. Physical restraint prescriptions were at 80%, whereas the 24 hours renewal rate was 0%. But, according to EHPAD, regular renewals ranged from one month to one year. EHPAD is obliged to put in place protocols to compensate caregivers for the difficulties they experience when following the recommendation even though these personnel are well aware and trained. This, especially because a legal loophole exists and because it is the necessity or the non-necessity that opens the way for a complaint to be made. The doctors reconcile their patients’ needs as best they can, as well as their ability to follow the recommendations.Conclusion: ANAES 2000’s best practice recommendation concerning passive physical restraint for older people is too strict to be applied in a GP situation. Therefore it appears that a specifically tailored recommendation should be written up for the use of general practitioners and EHPAD coordinators.
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Master Thesis
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Amandine Plessi. Analyse de la pratique de la contention et du rôle du médecin traitant dans deux EHPAD de la région bordelaise en juin 2018. Médecine humaine et pathologie. 2018. ⟨dumas-02064935⟩

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