Physical Restraint Reduction in the Acute Rehabilitation Setting

Abstract

A prospective, continuous quality improvement study was implemented at a hospital on two rehabilitation units: stroke and brain injury. The purpose of the study was to decrease restraint use by 25% and to maintain fall rates no greater than 10% over baseline. A multi-component restraint reduction program was implemented that focused on administrative support, education, consultation, and feedback. Monthly restraint rates and fall rates were monitored and compared to the previous year's rates. Both units reduced restraint use. Importantly, this reduction was accomplished at the same time as a decline in fall rates.

A Controlled Quality Improvement Trial to Reduce the Use of Physical Restraints in Older Hospitalized Adults

“…The reduction in physical restraint use was not shown to increase fall reports on the units. Although information on why restraints were being used was not available, the fact that falls did not increase as physical restraint use decreased is consistent with the literature …”

The impact of education and training interventions for nurses and other health care staff involved in the delivery of stroke care: An integrative review

“…One study was an interrupted time series 24 . The remaining studies used quasi-experimental designs: eight were pretest-posttest 9,13,[25][26][27][28][29][30] , five were non-equivalent groups 15,17,19,20,31 and one was a post-test study 14 . Details of study characteristics are summarised in Table 2.…”

“…Over half the studies involved the education or training of nurses (57%). All but one study 25 reported the number of patients included in outcome measurements, which totalled 9,913 across 20 studies (median 495, range 37 to 1696).…”

Effectiveness of Multifactorial Intervention on Observance of Physical Restraint Standards of the Patients Hospitalized in Intensive Care Units

“…This issue is contradictory to different supervisions and standards related to the reduction or prevention of physical restraint in other health-therapeutic centers (18). Nurses used physical restraint as a part of therapeutic methods in different units for many years (19), but the use of physical restraint technique is a controversial issue (20).…”