A retrospective study on the outcomes of a collaborative restraint reduction project by a residential home for older people and a hospital-based community geriatric assessment service

This study examined whether there was any relationship between fall and restraint rates prior to and after implementation of a restraint reduction program in an old age home. Demographic and clinical data on subject variables were collected for statistical analysis over three time periods, each lasting 12 months -1995 (T1), 1997 (T2), and 1998 (T3). T1 was one year prior to joint efforts by the Home and a Community Geriatric Assessment Service. T2 and T3 were the two consecutive years after restraint reduction interventions were progressively instituted in 1996. Subjects included residents of the Care and Attention (C & A) section of the Home within the three time periods. Treating subjects in T1, T1 and T3 as three independent samples showed no significant differences comparing restraint rates and fall rates between the time periods. Significant difference was noted, however, when comparing "insignificant/minor falls" against "serious falls" (p=0.040) between T1 and T2. The decrease in the number of "serious falls" remained stable in T3. Although the number of falls neither increased nor decreased in the three time periods, the absolute number of minor falls increased and the number serious falls decreased after implementing the fall prevention program. The degree of change was stable two years after program implementation. The number of falls a resident sustained had a low level of correlation with his/her restraint status. Study findings show that the restraint reduction program resulted in some positive outcomes for Home residents.