Nursing home recognized for dramatic reduction in physical restraint use

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A New Jersey nursing facility was recently honored for dramatically reducing physical restraint use among its residents.

In 2008, fully 8% of the residents at the Christian Health Care Center in Wyckoff were being physically restrained. By the third quarter of last year, the rate had dropped to 1.6%.

The staff credits a new approach to caregiving for the dramatic change. By using restraints only when needed, they cut use by more than 75%. Betty Grieve, R.N., the facility's charge nurse, said educating residents and their families about restraint-prevention was also critical, according to a report from She said the nursing staff used bed and chair alarms, and other tools, including low beds and mattresses on the floor, padded underwear, treaded socks and wristbands to identify at-risk residents. The staff also rounded on patients frequently, emphasizing “the four Ps:” pain, potty, positioning and personal needs, according to

Physical restraints are identified as any method or device attached to the resident's body — and which they cannot easily remove — that restricts freedom of movement. Excessive use of restraints can be linked to resident falls, dehydration, agitation, depression and other psychological issues.

Healthcare Quality Strategies Inc., the Medicare-designated quality-improvement organization for New Jersey, launched an initiative in 2008 to reduce the use of restraints in nursing homes by 20%.

Christian Health Care Center was one of 20 New Jersey nursing homes with a physical restraint rate above 6% when the initiative was launched.