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Change in the Rate of Restraint Use and Falls on a Psychogeriatric Inpatient Unit: Impact of the Health Care Financing Administration's New Restraint and Seclusion Standards for Hospitals

Michelle Spurlock, RN, BSN

This chart review of 767 patients treated on a psychogeriatric inpatient unit over a 2-year period examined the impact of the Health Care Financing Administration's (HCFA) new restraint standards for hospitals on the rate of restraint use and falls. There was a marked decrease in the number of restraint episodes in the year after the intro duction of the new standards compared with the year before (44 vs 212 restraint episodes per 1000 patient-days). However, no notable differences were found in the number of total falls (18 vs 21 falls per 1000 patient-days) or serious falls (2 vs 1 serious fall per 1000 patient-days). If replicated, these findings of decreased restraint use with out a concomitant increase in the number of falls demonstrate a change in practice patterns as a result of HCFA's action. (J Geriatr Psychiatry Neurol 2002; 15:91-94).

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