Restraint Reduction: Regulations, Alternatives and Therapy Intervention

By Kathleen D. Weissberg, MS, OTR/L

…The state survey guidelines state that the resident has the right to be free from any physical or chemical restraints imposed for the purposes of discipline or convenience and not required to treat the resident’s medical symptoms. This comes directly from the State Survey Guidelines tags F221 which relates to physical restraints and F222 which relates to chemical restraints. Obviously we know that restraint reduction is a critical area that is going to impact quality care. We have a common goal as therapists and as all healthcare practitioners of enhancing quality of life and the OBRA mandate. OBRA stands for the Omnibus Budget Reconciliation Act that was passed by President Reagan many years ago and mandates that our state surveyors recognize the detrimental effects of restraint usage. To that end, you have seen so many facilities over the last 10+ years really focus on reducing their restraints. Many of which now have become restraint free. It goes further on in the state survey guidelines to state that it is expected that for those residents whose care plans indicate the need for restraints, that the facility engage in a systematic and gradual process toward reducing restraints, for example gradually increasing the time for ambulation and muscle strengthening activities. To read more, click here.

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