TY  - JOUR
PY  - 1999//
TI  - Restraint reduction reduces serious injuries among nursing home residents
JO  - Journal of the American Geriatrics Society
A1  - Neufeld, R. R.
A1  - Libow, L. S.
A1  - Foley, W. J.
A1  - Dunbar, J. M.
A1  - Cohen, C.
A1  - Breuer, B.
SP  - 1202
EP  - 1207
VL  - 47
IS  - 10
N2  - OBJECTIVES: To describe how removing physical restraints affected injuries in nursing home settings. DESIGN: A 2-year prospective study of an educational intervention for physical restraint reduction. SETTING: Sixteen diverse nursing homes with 2075 beds in California, Michigan, New York, and North Carolina. PARTICIPANTS: Study A: 859 residents who were physically restrained at the onset of the intervention on October 1, 1991. Study B: all residents who occupied the 2075 beds in the 16 facilities 3 months before the intervention and 3 months after its completion. INTERVENTION: Educational program for nursing home staff followed by quarterly site consultations to participating nursing homes. MAIN OUTCOME MEASURES: Rate of physical restraint use and injuries. RESULTS: Study A: Serious injuries declined significantly among the 859 residents restrained initially when restraint orders were discontinued (X2 = 6.2, P = .013). Study B: During the intervention period, physical restraint use among the 2075 residents decreased from 41% to 4%, a 90% reduction. The decrease in the percentage of injuries of moderate to serious severity was significant (i.e., 7.5% vs 4.4%, P2-tail = .0004) as was the rate of moderate and serious injuries combined (Rate Ratio = 1.580, P2-tail = .0033). CONCLUSIONS: A substantial decrease in restraint use occurred without an increase in serious injuries. Although minor injuries and falls increased, restraint-free care is safe when a comprehensive assessment is done and restraint alternatives are used.<p /> <p>Language: en</p>
LA  - en
SN  - 0002-8614
UR  - http://dx.doi.org/
ID  - ref1
ER  -