Limiting Physical Restraint Use

Physical restraints are defined by the Centers for Medicare & Medicaid Services (CMS) as “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one’s body” (42 CFR 483.13(a)).

Although the use of physical restraints is not prohibited, CMS continues to encourage nursing home providers to reduce their use. There is a common misconception that restraints are necessary to ensure safety. Research shows that this belief is generally unfounded. Far outweighed by the possible benefits is a long list of risks including:

• Urinary incontinence
• Increased agitation
• Circulation problems
• Pressure ulcers (bed sores)
• Decreased mobility
• Physiologic stressors
• Social isolation
• Reduced sensory input

Benefits of refraining from restraint use have been well documented and include improvement in quality of life, greater autonomy, reduction in use of anti-psychotic medications, less skin breakdown and a reduction in seriousness of injuries due to falls.

Fall Prevention Resources
Physical Restraints Tracking Tool - Blank Dashboard - Sample Data Dashboard
Fall Risk Assessment
Tinetti Mobility Assessment Tool
Fall Investigation Report #1
Fall Investigation Report #2
Falls Prevention Intervention Plan of Care
Post Fall Investigation Report
Wheelchair Seating Assessment