Training Can Reduce Use of Unnecessary Nursing Home Restraints: Study

Simple retraining and education programs could reduce the use of physical restraints in nursing homes by nearly one-third, according to new research. 

In a report published this month in the Journal of the American Medical Association, researchers from several German universities indicate that they have developed a guideline-based multicomponent intervention program, which is designed to get some nursing home workers to stop using physical restraints on their residents.

According to the study, more than 20% of nursing homes employ physical restraints that prevent elderly residents from being able to move. Such restraints can include belts, bilateral bed rails and fixed tables in a chair, which could pose an injury risk and create more problems than they solve.

Researchers looked at 3,771 nursing home residents in 36 German facilities. In half of those nursing homes, nurses were presented with new guidelines, education, presentations and endorsement from nursing home leaders aimed at reducing physical restraint use. At the start of the study, those nursing homes were physically restraining about 31.5% of their residents. Six months after the intervention program, the rate had dropped to 22.6%. In nursing homes where there was no intervention program, the rates stayed about the same.

The study detected no change in the number of nursing home falls and fractures or in prescribed medications.

According to the researchers, their program worked because it was designed to create a culture in the nursing homes that avoided the use of physical restraints that affected all of the employees. Previous attempts that only targeted select personnel in nursing homes had failed or produced inconsistent results, the researchers said.