Physical Restraint and Fall Management Resources

These resources are primarily for nursing home use, but hospital staff may find them useful as well.

"Achieving Restraint Reduction without Increasing Falls" by Betsy Willy, PT

WebEx on strategies to reduce physical restraint utilization without increasing falls.

Berg Balance Scale
The Berg Balance Scale is a reliable and valid measure that is used to assess a resident's balance in sitting postures, standing postures, and while moving.

Clarification of Terms Used in the Definition of Physical Restraints as Applied to the Requirements for Long-term Care Facilities
June 22, 2007, memo from the Center for Medicaid and State Operations/Survey and Certification Group to State Survey Agency Directors.

Comprehensive Assessment and Evaluation
Key steps and key elements

Decision Tree
Actions to take when a physically restrainted patient is admitted to the facility

Development of Plan of Care
Key steps and key elements

Eliminating Restraints without Increasing Falls teleconference
A recorded teleconference featuring Betsy Willy, MA, PT, FCCWS, of Pathway Health Services

Everyone Deserves Quality of LIfe: What You Need to Know About Physical Restraints in Nursing Homes
A guide for residents and family

Example Policy and Procedure: Restraint-free Environment in the Nursing Home
Courtesy of Schofield Residence, Kenmore, NY; Robert S. Stall, MD, Medical Director; Geriatrics; Hospice Care for Patients, Caregivers and Health Professionals

Facility Assessment Checklist for Physical Restraints
Facility assessment checklists are tools used to assess current physical restraint management systems and identify areas for improvement. These checklists are designed for completion by a director of nursing or other team leader who knows the facility's processes of care.

Falls Management Program
This interdisciplinary program, developed by the Emory Center for Health in Aging, is designed to assist nursing facilities in improving their fall care processes and outcomes through educational and quality improvement tools.

New Mexico Physical Restraint Collaborative Framework
Modeled after the Institute for Healthcare Improvement, the New Mexico Physical Restraint Collaborative began in 2009 to provide the foundation necessary for staff to reduce and/or eliminate physical restraints in their facility while promoting the development of relationships between leadership, staff and residents.

Organizational Commitment to Restraint-free Environment
Key steps and key elements

Percent of Residents in Physical Restraints Quality Measure Description
The percent of residents who are restrained daily

Physical Restraint Jeopardy
A game that can be used with nursing home staff members to educate them about restraint use

Physical Restraints Crossword
A crossword puzzle that contains terms related to the use of physical restraints

Powerful Reality Comprehension Clock Test WebEx
This WebEx recording features Barbara Brock, the original creator of the Reality Comprehension Clock Test (RCCT) and the social model for dementia known as Communication Art Programs.

Process for Eliminating Physical Restraints in Long-term Care
From Untie the Elderly, The Kendal Corporation

Restraint Alternatives
Here are a list of ideas for reducing physical restraint use. Carefully monitored use of these alternatives with frequent reassessment is suggested.

Restraints: Facility Assessments
Identify what processes of care your facility has in place and what areas need improvement

Staff Attitudinal Survey and Answer Key
Survey and answer key to determine staff attitudes related to restraint use in a nursing home

Training and Education
Key steps and key elements