title: 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.
abstract: 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 introduction of the new standards compared with the year before (44 vs 212 restraint episodes per 1,000 patient-days). However, no notable differences were found in the number of total falls (18 vs 21 falls per 1,000 patient-days) or serious falls (2 vs 1 serious fall per 1,000 patient-days). If replicated, these findings of decreased restraint use without a concomitant increase in the number of falls demonstrate a change in practice patterns as a result of HCFA's action.
authors.affiliation: Section on Geriatric Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.forename: Michelle
authors.initials: M
authors.lastname: Spurlock
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000375:Aging; D014487:Centers for Medicare and Medicaid Services, U.S. / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000191:economics*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States