title: Reducing Physical Restraints in Nursing Homes: A Report From Maria Wolff and Sanitas.
abstract: Physical restraints are associated with severe side effects and suffering. A comprehensive, person-centered, methodology was implemented in 41 Spanish nursing homes to safely eliminate restraints.
  
  
  
  Data were collected in 2 waves: September 2011 (at the beginning of the intervention, n = 4361) and September 2014 (n = 5051). Use of 10 different types of physical restraints was recorded, as well as frequency of psychotropic medication prescription, falls, and mortality.
  
  
  
  Mean age was 83.4 (SD 8.5) and 63.5% of the residents had dementia. Frequency (95% confidence interval) of people having at least 1 restraint was reduced from 18.1% (17.0-19.3) to 1.6% (1.3-2.0). Use of benzodiazepines was also reduced, with no significant changes in other psychotropic medications and mortality. The rate of total falls increased from 13.1% (12.1-14.1) to 16.1% (15.1-17.1), with no significant increase in injurious falls.
  
  
  
  Physical restraints can almost completely be eliminated with reasonable levels of safety.
authors.affiliation: Maria Wolff Foundation, Madrid, Spain.
authors.forename: Ruben
authors.initials: R
authors.lastname: Muñiz
authors.affiliation: BUPA-SLA Sanitas, Mayores, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Gómez
authors.affiliation: BUPA-SLA Sanitas, Mayores, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Curto
authors.affiliation: BUPA-SLA Sanitas, Mayores, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Hernández
authors.affiliation: BUPA-SLA Sanitas, Mayores, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Marco
authors.affiliation: Government of Navarra, Pamplona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: García
authors.affiliation: BUPA-SLA Sanitas, Mayores, Spain.
authors.forename: José F
authors.initials: JF
authors.lastname: Tomás
authors.affiliation: Maria Wolff Foundation, Madrid, Spain; Gregorio Marañón University Hospital, Madrid, Spain. Electronic address: javier@mariawolff.es.
authors.forename: Javier
authors.initials: J
authors.lastname: Olazarán
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009735:Nursing Homes; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013030:Spain
chemical_list: D011619:Psychotropic Drugs
keywords: Elderly; fall; injurious fall; nursing home; physical restraint; psychotropic medications