Restraint Reduction Reduces Serious Injuries Among Nursing Home Residents

Abstract

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.

Differences in Period Prevalence of the Use of Physical Restraints in Elderly Inpatients of European Hospitals and Nursing Homes

“…The most common indication for use of PR was high risk of falls. The validity of this indication is questioned by studies showing a lower fall or injury incidence during restraint reduction in nursing homes (12,13). The difference in the use of PR for more than 24 hours between hospitals and nursing homes, although not justified by it, can probably be explained by the higher number of acutely ill cognitively impaired patients in geriatric hospital wards.…”

“…Many adverse effects of PR use have been reported (3)(4)(5)(6). Proposed but debatable reasons for the use of physical restraints include protection of confused elderly in the case of severe psychomotor agitation, delirium, increased risk of falling, or to enable treatment (7)(8)(9)(10).…”

Probleemgedrag, wat doe je eraan?

“…Bovendien verhoogt de immobiliteit die met fixatie gepaard gaat het valrisico, doordat zij spierzwakte veroorzaakt. 47 Naast deze 'bijwerkingen' zijn er jaarlijks een aantal incidenten geweest met dodelijke afloop in situaties waar Zweedse banden werden toegepast.…”

Falls and Fractures

“…Injurious falls were halved by reducing physical restraint use. 34 Consultant pharmacies should review medications in all persons with a fall. The hazard ratio for a fall was reduced to 0.48 with the withdrawal of fallrisk-increasing drugs.…”