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Use of Physical Restraints in Wisconsin Nursing Homes

PDF Version of BQA 00-032 (PDF, 5 KB)

Date: March 30, 2000 DSL-BQA-00-032

To: Nursing Homes NH 16

From: La Vern Woodford, Chief, Resident Care Review Section
Susan Schroeder, Director, Bureau of Quality Assurance

We would like to take this opportunity to congratulate all Wisconsin nursing homes on the efforts they have made to reduce the use of physical restraints. Less than four years ago, only Alaska had a greater percentage of nursing home residents in restraints than Wisconsin. At that time, almost one-third (32.4 percent) of Wisconsin nursing home residents were in restraints, nearly twice the national average. Today, for the first time, Wisconsin nursing homes are below the national average in using physical restraints. Physical restraint use in Wisconsin nursing homes as of March 2000 is 10.9 percent compared to a national average of 11 percent. This change reflects the tremendous amount of effort nursing homes have made to reduce restraint use and to find alternative methods for ensuring resident safety.

This change is even more remarkable when we consider the changes in resident characteristics that have occurred since July 1996. At that time, 26 percent of Wisconsin nursing home residents required assistance with ambulating. In March 2000, this number rose to 42 percent. In July 1996, 21 percent of residents displayed behavior symptoms and 39 percent had some form of dementia. Today, these numbers are 30 percent displaying behavior symptoms and 44 percent with some form of dementia. In the past, as nursing homes admitted more residents with these characteristics, there would possibly have been a greater use of restraints to manage these residents and their behaviors. The ability of nursing homes to reduce the use of physical restraints, in spite of these changes in residents, reflects the efforts and hard work put forth by their staff.

Thank you for the efforts you have made to reduce restraint usage and to work toward the goal of ensuring that only those residents who require a restraint to treat a medical symptom, as determined by an individualized comprehensive assessment, are restrained. We hope you will pass our congratulations on to all your staff.

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