Use of Restraints

Physical restraints are defined as anything that is used to keep a person from moving around or moving a part of the body, such as bed rails or belts that keep a person in bed, wrist or ankle restraints, or trays, bars, belts and other devices that keep an able person from getting out of a wheelchair.

While their use may sometimes be medically necessary for a nursing home resident, physical restraints can actually cause health problems, including stiff joints, bed sores, weak bones and muscles, dehydration, pneumonia, falls and even death. Physical restraints should only be used when ordered by a physician to treat medical symptoms. Federal law prohibits using physical restraints “for the purposes of discipline or convenience.”

Reducing the use of physical restraints is a focus of the Centers for Medicare and Medicaid Services’ National Patient Safety Initiative (or NPSI, formerly known as the Nursing Home Quality Initiative). The Arkansas Foundation for Medical Care is leading this effort in Arkansas by providing training for nursing home staff members and creating educational tools for providers and residents’ family members.
Although there is still room for improvement, Arkansas’ nursing homes have made excellent progress: When the NHQI/NPSI started in 2002, Arkansas’ physical restraint use rate was above 22 percent. By the fourth quarter of 2008, it was down to 6 percent.

Presentation on Use of Restraints in Nursing Homes
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