In 2011, a nursing home in Tennessee had nearly a 30 percent restraint rate, with approximately 50 residents in some form of restraint.Three years later, they’re down to one. How did they do it?
They began by assessing one resident at a time.
The staff worked closely with the Director of Therapy Services to determine the root cause of each restraint used. They observed residents and met weekly to review falls and restraints.
They discussed every resident, one at a time, to determine how to ease each one out of a restraint.
The biggest challenge to this effort came from families who feared their loved ones would fall if not restrained.
The staff consistently educated families about the ineffectiveness of restraints, providing articles and information, but that still wasn’t enough.
Families wanted options.
So they offered alternatives, such as moving the resident from a standard wheelchair to a reclining or tilt-in-space chair. They also provided trial periods to demonstrate the safety of the restraint removal.
To encourage staff members to get out of the habit of reaching for a lap belt, facility administrators removed every belt in the building.
After all, it’s easier to remove restraints when there aren’t any to be found.
When the facility’s fall rate didn’t increase with the reduction in restraints, the staff became believers and advocates in providing a restraint-free environment.
As a Quality Improvement Advisor, I have personally worked with nursing homes across Tennessee to help them improve quality of care through restraint reduction and am continuing this work with the atom Alliance for the next five years.
I applaud the healthcare professionals—the boots on the ground—doing the work and their willingness to change to benefit the residents they serve.
Learn more about how to reduce restraints at atom Alliance’s Improving Mobility webpage. There, facilities can find tools like these:
Patients, family members and caregivers can find more information here.