title: Nursing home deficiency citations for physical restraints and restrictive side rails.
abstract: This article examines whether nursing home facility-level characteristics are associated with the likelihood of receiving deficiency citations for physical restraints, including restrictive side rails. Data from the on-line survey certification of automated records were used to calculate odds ratios for facility-level characteristics associated with these deficiency citations. Repeat records from 2000 to 2007 were combined to produce longitudinal data. The results of this study show that restraint/side rail deficiency citations were negatively associated with higher staffing levels of registered nurses and licensed practical nurses (p ≤ .001) and higher Medicaid reimbursement rates (p ≤ .01). Citations were positively associated with greater nurse aide staffing (p ≤ .01) and higher quality-of-care deficiency citation percentiles (p ≤ .001). The extent of physical restraint and restrictive side rail misuse within nursing homes appears to vary according to various facility characteristics. It is less clear how internal processes within a facility bring about these observed patterns of variation.
authors.affiliation: New York University College of Nursing, New York 10003, USA. lmw9@nyu.edu
authors.forename: Laura M
authors.initials: LM
authors.lastname: Wagner
authors.forename: Shawna M
authors.initials: SM
authors.lastname: McDonald
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Castle
mesh_terms: D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008484:Medicaid; D009735:Nursing Homes / Q000331:legislation & jurisprudence / Q000592:standards*; D010561:Personnel Staffing and Scheduling; D011787:Quality of Health Care; D012149:Restraint, Physical / Q000331:legislation & jurisprudence*; D014481:United States