Restraints

Physical restraints used on a daily basis can cause a number of adverse medical outcomes such as decreased mobility, impaired circulation, incontinence, pressure ulcers, bruises, increased confusion, and loss of dignity. Contrary to popular belief, restraints do not prevent falls and often contribute to injuries and death.

A physical restraint is defined as “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily that restricts freedom of movement or normal access to one’s body.” It is the effect on the resident, rather than the name or intended use that determines whether or not it is classified as a restraint device.

Effective prevention programs require support from organizational leadership, education and ensuring physical restraint reduction is a priority to all staff. Standardization of processes is key along with measuring and evaluating tests of change from using quality improvement methods and tools. Reducing physical restraints by focusing on one resident at a time works best.

Evidence from the Centers for Medicare & Medicaid Services suggests physical restraint reduction through health care process and system redesign can improve safety. Organizations that have worked with IFMC - IL have shown an improvement in the reduction of restraint use versus the statewide average reduction in rate. IFMC - IL continues to partner with clinical and skilled nursing facility staff to implement system changes that impact the identification and documentation of appropriate restraint reduction.

For more information on reduction to the use of restraints, contact the Nursing Home Quality Improvement Team at 1-800-386-6431.