@article{
 title = {A Controlled Quality Improvement Trial to Reduce the Use of Physical Restraints in Older Hospitalized Adults},
 type = {article},
 year = {2014},
 identifiers = {[object Object]},
 keywords = {acute care,elderly,physical restraints,quality improvement},
 month = {2},
 publisher = {The American Geriatrics Society},
 day = {12},
 city = {Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health Services, Calgary, Alberta, Canada.},
 id = {7aee47bf-5a1a-3781-80fc-1d53b853666b},
 created = {2016-08-21T22:18:52.000Z},
 file_attached = {false},
 profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
 group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
 last_modified = {2017-03-14T09:54:45.334Z},
 read = {false},
 starred = {false},
 authored = {false},
 confirmed = {true},
 hidden = {false},
 source_type = {JOUR},
 notes = {ID: 68398; CI: (c) 2014, Copyright the Authors Journal compilation (c) 2014; JID: 7503062; OTO: NOTNLM; aheadofprint},
 folder_uuids = {4da8a58e-a2c5-4458-a19c-93e568b77eb4},
 private_publication = {false},
 abstract = {OBJECTIVES: To implement and evaluate an evidence-informed multicomponent strategy to reduce physical restraint use in older adults admitted to acute care medical units. DESIGN: Stepped-wedge trial. SETTING: Four acute care medical units in Calgary, Alberta, over a 4-month time period. PARTICIPANTS: Data were collected from individuals aged 65 and older present on the study units during monthly restraint audits. INTERVENTION: Development of opinion leaders among the nursing leadership, education and training of physicians and unit nurses, and implementation of least restraint rounds. MEASUREMENTS: The primary outcome was rate of restraint use as determined from walk-around audits. Secondary outcomes included number of physician orders for physical restraints on the electronic medical record and fall reports. RESULTS: Thirteen percent to 27% of individuals were being restrained on the medical units before the intervention, with the vast majority of restraints being bed rails. This decreased to 7% to 14% after the intervention. The intervention resulted in a statistically significant reduction in restraint use measured in the early mornings (P = .01), and this trend continued after adjusting for unit and month (P = .06). Similarly, the rate of restraint use trended down at all other measured time periods but was not statistically significant. A limited number of individuals had an order for physical restraint within their electronic medical record (3% before, 2% after the intervention). The median number of monthly fall reports did not change (three before, three after; P = .60). CONCLUSION: A multicomponent team-focused quality improvement intervention has the potential to decrease the use of physical restraints in older hospitalized adults.},
 bibtype = {article},
 author = {Enns, E and Rhemtulla, R and Ewa, V and Fruetel, K and Holroyd-Leduc, J M},
 journal = {Journal of the American Geriatrics Society}
}

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DESIGN: Stepped-wedge trial. SETTING: Four acute care medical units in Calgary, Alberta, over a 4-month time period. PARTICIPANTS: Data were collected from individuals aged 65 and older present on the study units during monthly restraint audits. INTERVENTION: Development of opinion leaders among the nursing leadership, education and training of physicians and unit nurses, and implementation of least restraint rounds. MEASUREMENTS: The primary outcome was rate of restraint use as determined from walk-around audits. Secondary outcomes included number of physician orders for physical restraints on the electronic medical record and fall reports. RESULTS: Thirteen percent to 27% of individuals were being restrained on the medical units before the intervention, with the vast majority of restraints being bed rails. This decreased to 7% to 14% after the intervention. The intervention resulted in a statistically significant reduction in restraint use measured in the early mornings (P = .01), and this trend continued after adjusting for unit and month (P = .06). Similarly, the rate of restraint use trended down at all other measured time periods but was not statistically significant. A limited number of individuals had an order for physical restraint within their electronic medical record (3% before, 2% after the intervention). The median number of monthly fall reports did not change (three before, three after; P = .60). CONCLUSION: A multicomponent team-focused quality improvement intervention has the potential to decrease the use of physical restraints in older hospitalized adults.","bibtype":"article","author":"Enns, E and Rhemtulla, R and Ewa, V and Fruetel, K and Holroyd-Leduc, J M","journal":"Journal of the American Geriatrics Society","bibtex":"@article{\n title = {A Controlled Quality Improvement Trial to Reduce the Use of Physical Restraints in Older Hospitalized Adults},\n type = {article},\n year = {2014},\n identifiers = {[object Object]},\n keywords = {acute care,elderly,physical restraints,quality improvement},\n month = {2},\n publisher = {The American Geriatrics Society},\n day = {12},\n city = {Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health Services, Calgary, Alberta, Canada.},\n id = {7aee47bf-5a1a-3781-80fc-1d53b853666b},\n created = {2016-08-21T22:18:52.000Z},\n file_attached = {false},\n profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},\n group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},\n last_modified = {2017-03-14T09:54:45.334Z},\n read = {false},\n starred = {false},\n authored = {false},\n confirmed = {true},\n hidden = {false},\n source_type = {JOUR},\n notes = {ID: 68398; CI: (c) 2014, Copyright the Authors Journal compilation (c) 2014; JID: 7503062; OTO: NOTNLM; aheadofprint},\n folder_uuids = {4da8a58e-a2c5-4458-a19c-93e568b77eb4},\n private_publication = {false},\n abstract = {OBJECTIVES: To implement and evaluate an evidence-informed multicomponent strategy to reduce physical restraint use in older adults admitted to acute care medical units. 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The intervention resulted in a statistically significant reduction in restraint use measured in the early mornings (P = .01), and this trend continued after adjusting for unit and month (P = .06). Similarly, the rate of restraint use trended down at all other measured time periods but was not statistically significant. A limited number of individuals had an order for physical restraint within their electronic medical record (3% before, 2% after the intervention). The median number of monthly fall reports did not change (three before, three after; P = .60). 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