Can physically restrained nursing-home residents be untied safely? Intervention and evaluation design

Abstract

Objective: To develop an intervention that will enable nursing home personnel to remove physical restraints from nursing-home residents safely and cost effectively.

Design: A multicenter prospective pre-post study.

Setting: Sixteen high-restraint-use nursing homes, four each from California, Michigan, New York, and North Carolina. The 16 facilities have 2075 beds.

Intervention: A 2-year educational demonstration study, including a 2-day workshop, specially prepared written and video materials, and telephone and on-site clinical consultations. Each nursing home designated a nurse to be the clinical coordinator and to lead a multidisciplinary team in conducting a restraint assessment and devising interventions for removal.

Outcome measures: We compared pre- and post-study aggregate and individual facility rates of restraint use, incidents and accidents, family attitudes, financial impact, serious injuries, and staff attitudes and work patterns.

Conclusion: Preliminary data suggest that this intervention was well received and appears to be effective in achieving restraint-free care.