A recent study of over 2,300 nursing home falls and fractures revealed that bedrails protect residents from falls when sedative use is also reduced. The study highlighted the danger of oversedating patients who use restraints. According to the study, antidepressants increased the risk of falling almost 50%, anti-psychotic drugs increased fall risks by almost 100%, and the fall risks for patients who take sleeping pills with benzodiazapines increased by almost 200%. Read a summary of the research. Despite the benefits of bedrails and wheelchair seatbelts, however, the researchers cautioned that nursing homes should preserve patient independence when possible and that restraints can themselves cause injury.
Even though bedrails, wheelchair seatbelts, and other restraints have been given a bad rap over the past decade, they do serve an important purpose with residents who are fall risks. I've long thought that part of the push to reduce physical restraint use was misplaced. This study confirms it. Instead of criticizing and minimizing the use of physical restraints alone, perhaps our criticism should have been directed to the use of physical restraints in those patients who were also chemically restrained by being oversedated. By reducing sedative use, patients might be more alert and better able to avoid the risks that are posed by physical restraints. If we're as vigilant and critical about chemical restraints as regulators have been about physical restraints, perhaps we can eliminate all chemical restraints.
Posted on Wed, January 16, 2008
by Robert Carter