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Nursing home survey deficiencies for physical restraint use
1Department of Health Administration and Policy, Medical University of South Carolina, Charleston 29425, USA.
Medical Care
|October 1, 1995
Summary
Despite new federal regulations, nearly one-third of North Carolina nursing home residents remained physically restrained in 1991. Staffing ratios and resident disability levels influenced restraint use, while facility size and costs correlated with violations.
Area of Science:
- Gerontology
- Health Policy
- Nursing Home Care
Background:
- Federal regulations enacted in 1990 aimed to significantly reduce physical restraint use in nursing homes nationwide.
- This study investigates the immediate impact of these regulations on North Carolina nursing homes in the year following implementation.
Purpose of the Study:
- To evaluate the effectiveness of new federal regulations on physical restraint use in North Carolina nursing homes.
- To identify facility-level factors associated with both the proportion of restrained residents and restraint regulation violations.
Main Methods:
- Analysis of annual health department surveys from 195 North Carolina nursing homes conducted in 1991.
- Utilized estimated weighted least-squares regression to model the proportion of restrained residents.
- Employed a probit model to predict the likelihood of a facility receiving a restraint violation citation.
Main Results:
- In 1991, an average of 32.6% of nursing home residents in North Carolina were physically restrained.
- 29.2% of facilities were cited for violations of restraint regulations.
- Key factors associated with restraint use included staff-to-resident ratios and resident disability levels. Violations were linked to facility size, costs, restraint proportion, and resident characteristics like organic brain syndrome.
Conclusions:
- Despite federal regulations, a substantial proportion of North Carolina nursing home residents remained physically restrained in the first year post-implementation.
- Identifying facilities with high restraint use or violation rates is crucial for targeted interventions.
- Findings can inform the development of educational programs and support systems to aid facilities in reducing physical restraint dependency.
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