Note You must complete the free registration to access the information on this website. Restraint Toolkit helps nursing home staff with restraint reduction efforts.Tools: Physical Restraints (PDF format) includes information about basic assessment, assessment tools, falls, behavior problems, wandering and medical necessity.Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes is a guide for providing quality care to residents with dementia, and include recommendations for providing care without the use of physical restraints.Systems Summary/Technical Assistance Sheet.Evidence-Based Best Practice for Use and Management of Mechanical Restraints (PDF).Close attention to the person's comfort, safety and needs for hydration, elimination, exercise and social interaction is essential while the restraint is in use. Using a restraint should be the last resort, even when a justifiable medical indication is present. When all four side rails are used to prevent a patient from exiting the bed, this would be a restraint, however, raising fewer than four side rails when the bed has segmented side rails would not necessarily immobilize or reduce the ability of a patient to move freely. Physical restraints should only be used in rare circumstances, and only as a short-term measure. The number of raised side rails used may also be a factor. And other methods for managing wandering, behavioral issues and interference with medical devices have been found to be more effective. In fact, people who are restrained still fall, and are more likely to be seriously injured if the fall occurs while restrained. ![]() However, recent research has demonstrated that restraints do not prevent falls. For years, physical restraints have been viewed as an appropriate intervention to prevent falls, to manage wandering and/or behavioral disturbances, or to minimize tampering with medical devices (intravenous lines, feeding tubes, indwelling bladder catheters, etc.).
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