Use of physical restraints in nursing homes in New South Wales, Australia

A 48 item postal survey was completed voluntarily by 285/445 (64%) Directors of Nursing (hereafter DONs) of nursing homes in New South Wales, Australia, to obtain information about the use of physical restraints. Of a total of approximately 16,397 (11,719 females; 4678 males) residents of nursing homes from which information was obtained, 15.3% (2516) were physically restrained. Females comprised 11.2% (1839) and males 4.1% (677) of this group. The commonest forms of physical restraint were vests (25.3%), restraining belts (18.9%), bedrails (17.2%), lap trays (14.4%) and gerichairs (10.5%). The commonest patient-oriented reason for using physical restraints was to 'prevent falls' (84.2%) and the commonest nurse-oriented reasons were 'because no alternative exists' (39.6%) and 'to reduce legal liability' (20%). The correlation between the size of nursing homes (bed numbers) and the number of residents who were physically restrained was weak (r = 0.1771, alpha = 0.05), suggesting that nursing home size did not predict the use of physical restraints. Correlations between the total number of staff, the total number of untrained staff (Assistants In Nursing) and the number of residents who were physically restrained were also weak (r = 0.1792; 0.0921 respectively; alpha = 0.05), suggesting that these factors also had little predictive influence on the use of physical restraints. The findings of this research indicate that the extent to which physical restraints are currently being used in nursing homes in New South Wales should be of concern.