Institutional policy: use of restraints in extended care and nursing homes

1. The percentage of patients restrained on these nursing home and extended care units was 32%, similar to that for other nursing home studies. 2. The archetypical restrained patient was older, new on the unit, had altered thought processes and a high potential for injury, and required extensive nursing care. Typically, the type of restraint a patient wore was a vest posey, on the day shift while in his room. 3. The most frequent rationale given by nurses for applying restraints was to prevent patient falls; however, half the time, this rationale was not charted. 4. Upon examining institutional restraint policy, nurses should be prepared to implement changes in documentation format, provide staff education regarding restraint use and alternatives available, institute a rehabilitative and restorative nursing care and fall prevention program, redesign the physical environment, and designate adequate resources for an effective diversion activity program.