Limiting Physical Restraint Use
Starting in August, 2008, eQHealth began a three-year project to collaborate with a group of Louisiana nursing homes to reduce the use of physical restraints.
Physical restraints are defined by the Centers for Medicare & Medicaid Services (CMS) 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 which restricts freedom of movement or normal access to one’s body” (42 CFR 483.13(a)).
Although the use of physical restraints is not prohibited, CMS continues to encourage nursing home providers to reduce their use. There is a common perception that restraints are often necessary to ensure safety; however, research shows that this belief is generally unfounded. Far outweighed by the possible benefits is a long list of risks including:
• urinary incontinence,
• increased agitation,
• circulation problems,
• pressure ulcers (bed sores),
• decreased mobility,
• physiologic stressors,
• social isolation,
• reduced sensory input.
Benefits of refraining from restraint use have been well documented and include improvement in quality of life, greater autonomy, reduction in use of anti-psychotic medications, less skin breakdown and a reduction in seriousness of injuries due to falls.
