The effectiveness of physical restraints in reducing the occurrence of falls in elderly patients

Abstract

This dissertation evaluates the association between physical restraint use and the occurrence of falls in elderly patients. The research question, formulated through the PICO framework, is "Are Physical Restraints Effective in Reducing the Occurrence of Falls in Non-Dementia and Non-Alzheimer's Disease Suffering Elderly Patients Residing in Nursing Homes?" The population chosen consists of elderly patients residing in nursing homes, who do not suffer from dementia or Alzheimer's disease. The intervention is the use of physical restraints, and although the comparison is not directly mentioned in the question, it is taken to be the withholding of physical restraint use. Finally, the outcome is the reduction in fall occurrences. While the inclusion criteria include those elderly not suffering from dementia or Alzheimer's disease, as well as those living in nursing homes, elderly who suffer from dementia or Alzheimer's disease as well as those residing in acute hospitals or rehabilitation centres are excluded. When these criteria were applied, the number of studies retrieved from the literature search decreased from 26 to 11. These final studies were then critically appraised through the CASP tool checklists, specific to cohort and case-control studies. From the evidence, 3 main results were extracted: physical restraint use increased both the fall frequency and the injury rate; use of physical restraints or even a decrease in their use resulted in a stable fall rate and injury frequency; restraint reduction resulted in increased falls without injuries or non-serious injuries. The main conclusion was that the routine use of physical restraints was not supported. Recommendations include the implementation of alternative interventions, restraint reduction programs, and fall management programs; assessment and examination of each individual; enhanced individualised care; and providing information to both staff and relatives.