Page 32 - Reduction of coercive measures

Chapter 2
of a work shift; recorded registration could not be changed afterwards. Independent observers and second support staff members used a printed copy of the registration list. They had to tick at one of the options ‘applied’ or ‘not applied’.
Statistical analysis
In order to determine the reliability of registration of coercive measures the inter-rater agreement between the support staff member and both the observer and the second support staff member was examined by calculating Cohen’s Kappa. Variables were set up by date and time of shift, unit and person who registered, one of the support staff members or an independent observer. A Cohen’s Kappa of ≥ .50 was considered as at least a moderate agreement (Landis & Koch, 1977). A z-score was calculated to determine the difference between registrations in which the support staff member and both the observer and second support staff member did not agree on the use of a coercive measure. A phi coefficient was calculated to determine the associations between different types of coercive measures. A phi of ≥ .50 was considered as at least a moderately strong association (Cohen, 1988).
Part two – validation and implementation study
Participants
The panel of stakeholders, which was set up to validate results of the first part of the study, consisted of nine employees of the care organization, one resident representative, and the first three authors who acted as moderators. One year and seven months after the reliability study (part one) the implementation study was performed. By that time, 5 units did not meet the criterion of at least four residents anymore, and therefore 50 units out of the 55 units in study part one, participated in part two. From the 209 residents who were still included, a random selection of 30 residents was made to test the result of the implemented registration.
Procedure
In order to form a panel of stakeholders an email with information on the study and an invitation to participate in the panel was sent
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