Two articles reported on a groundbreaking study from the Journal of the American Medical Association that has proved the use of restrains to be unnecessary in nursing homes.  According to a study, nursing homes that simply increased staff training and provided supportive equipment had a lessened need for the use of restraints.   "Nursing home care does not necessitate the administration of physical restraints, as demonstrated by our own epidemiological research," the authors of the study said. "We found pronounced center variation, with best-practice centers applying very few physical restraints.”

In the study the experimental group received an intervention where they were trained and taught alternative methods to care for fall prone residents other than simply belting them down to their bed or wheelchair. The study proved the alternative intervention to be just as effective at preventing falls and fall related fractures as the use of restraints. 

It is obvious that there are much better alternatives than simply tying down a resident yet, today restraints are still being used on more than 20% of residents in U.S. nursing homes. Why is there still such a high prevalence of restrains when more effective, humane methods have been proved to be just as effective? The additional cost of the intervention could be the reason more nursing homes are not participating. Sadly, many nursing homes are of the mentality that if the method they have works why spend unnecessary funds on an alternative method, even if the new method could greatly improve their residents’ quality of life.

See articles at MSN Health and Nurses.com.  Find Study at JAMA. 2012;307(20):2177-2184. doi:10.1001/jama.2012.4517 orhere.

2 Thoughts on “JAMA Study on Restraints

  1. LF Safer, MD on December 5, 2012 at 9:08 pm said:

    Implementing use of restraints in a punitive manner or out of laziness and disregard is obviously an offensive solution.

    However, preventing injuries resulting from falling out of bed should be a primary concern that warrants evaluation of whether raising side rails is a viable option.

    If there are concerns about the space between spindles, the spindles should be manufactured or retro fitted closer together. Another alternative is to place a synthetic mesh around the spindles that would retard penetration and possible injury to a limb.

    It is never acceptable to permit falling out of a bed regardless if standard height or “low bed”.

    Emotionally charged references such as ” bed bars” should be avoided, as well.

    Side rails, like monetary currency, are neither good nor bad; how they are utilized and for what purpose are the key determinants, on a case-by-case basis.

    Common sense should prevail!

  2. LF Safer, MD on December 5, 2012 at 9:09 pm said:

    Implementing use of restraints in a punitive manner or out of laziness and disregard is obviously an offensive solution.

    However, preventing injuries resulting from falling out of bed should be a primary concern that warrants evaluation of whether raising side rails is a viable option.

    If there are concerns about the space between spindles, the spindles should be manufactured or retro fitted closer together. Another alternative is to place a synthetic mesh around the spindles that would retard penetration and possible injury to a limb.

    It is never acceptable to permit falling out of a bed regardless if standard height or “low bed”.

    Emotionally charged references such as ” bed bars” should be avoided, as well.

    Side rails, like monetary currency, are neither good nor bad; how they are utilized and for what purpose are the key determinants, on a case-by-case basis.

    Common sense should prevail!

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