title: Description of an advanced practice nursing consultative model to reduce restrictive siderail use in nursing homes.
abstract: Researchers have demonstrated that the use of physical restraints in nursing homes can be reduced, particularly where advanced practice nurses (APNs) are utilized. We examined the link between APN practice, siderail reduction, and the costs of siderail alternatives in 273 residents in four Philadelphia nursing homes. The majority of participants were cognitively and physically impaired with multiple co-morbidities. APNs recommended a total of 1,275 siderail-alternative interventions aimed at reducing fall risk. The median cost of siderail alternatives to prevent falls per resident was $135. Residents with a fall history experienced a significantly higher cost of recommendation compared to non-fallers. Findings suggest that an APN consultation model can effectively be implemented through comprehensive, individualized assessment without incurring substantial costs to the nursing home.
authors: Baycrest Centre for Geriatric Care, Kunin-Lunenfeld Applied Research Unit, 3560 Bathurst Street, Toronto, Ontario, Canada M6A 2E1. lwagner@klaru-baycrest.on.ca
authors: Laura M
authors: LM
authors: Wagner
authors: Elizabeth
authors: E
authors: Capezuti
authors: Barbara
authors: B
authors: Brush
authors: Marie
authors: M
authors: Boltz
authors: Susan
authors: S
authors: Renz
authors: Karen A
authors: KA
authors: Talerico
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001513:Beds; D003072:Cognition Disorders / Q000451:nursing; D003362:Cost-Benefit Analysis; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005851:Geriatric Nursing / Q000458:organization & administration; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000458:organization & administration; D009722:Nurse Practitioners / Q000458:organization & administration; D009730:Nursing Assessment / Q000458:organization & administration; D015403:Nursing Evaluation Research; D009735:Nursing Homes; D015143:Philadelphia; D012149:Restraint, Physical / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000458:organization & administration; D017751:Safety Management / Q000458:organization & administration*