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 OJN  Vol.2 No.3 , September 2012
Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals
Abstract: This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.
Cite this paper: Tzeng, H. and Yin, C. (2012) Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals. Open Journal of Nursing, 2, 170-175. doi: 10.4236/ojn.2012.23026.
References

[1]   Centers for Medicare & Medicaid Services (2012) State operations manual: Appendix A—Survey protocol, regulations and interpretive guidelines for hospitals. www.gnyha.org/2802/File.aspx

[2]   Hartford Institute for Geriatric Nursing (2008) Preventing falls in acute care. In: Capezuti, E., Zwicker, D. Mezey, M. and Fulmer, T., Eds., Evidence-Based Geriatric Nursing Protocols for Best Practice, 3rd Edition. Springer Publishing Company, New York, 161-198.

[3]   Tiessen, B., Deter, C., Snowdon, A. and Kolga, C. (2010) Continuing the journey to a culture of patient safety: From falls prevention to falls management. Healthcare Quarterly, 13, 79-83.

[4]   McCabe, D.E., Alvarez, C.D., McNulty, S.R. and Fitzpatrick, J.J. (2011) Perceptions of physical restraints use in the elderly among registered nurses and nurse assistants in a single acute care hospital. Geriatric Nursing, 32, 39-45. doi:10.1016/j.gerinurse.2010.10.010

[5]   Williams, J., Kaasalainen, S., Hadjistavropoulos, T., Scudds, R., Thorpe, L., Neville, S., Tremeer, J. and Andersen, D. (2011) A qualitative investigation of injurious falls in long-term care: Perspectives of staff members. Disability and Rehabilitation, 33, 423-432. doi:10.3109/09638288.2010.498555

[6]   Currie, L. (2008) Fall and injury prevention. In: R. G. Hughes, Ed., Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, 195-250.

[7]   Gray-Micelli, D. (2008) Preventing falls in acute care. In: Capezuti, E., Zwicker, D., Mezey, M. and Fulmer, T. Eds., Evidence-Based Geriatric Nursing Protocols for Best Practice, 3rd Edition, Springer Publishing, New York, 161-198.

[8]   Joint Commission (2005) Strategies for addressing the root causes of falls. In: Smith, I.J., Edition, Reducing the Risk of Falls in Your Health Care Organization, Joint Commission, Oakbrook Terrace, 29-50.

[9]   Inglesby, T. (2012) Preventing falls: The A-B-C approach. PSQH: Patient Safety & Quality Healthcare, 9, 46-51.

[10]   Clyburn, T.A. and Heydemann, J.A. (2011) Fall prevention in the elderly: Analysis and comprehensive review of methods used in the hospital and in the home. Journal of the American Academy of Orthopaedic Surgeons, 19, 402-409.

[11]   Donabedian, A. (1986) Criteria and standards for quality assessment and monitoring. Quality Research Bulletin, 12, 99-108.

[12]   National Quality Forum (2009) Safety practice 33: Falls prevention. In: Safe Practices for Better Healthcare— 2009 Update: A Consensus Report, National Quality Forum, Washington DC, 319-324.

[13]   The American Nurse Association, Inc. (ANA) (2009) The national database of nursing quality indicators: Description & glossary. American Nurses Association, Inc., Silver Spring.

 
 
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