@article{
 title = {Reducing Physical Restraints in Nursing Homes: A Report From Maria Wolff and Sanitas},
 type = {article},
 year = {2016},
 identifiers = {[object Object]},
 keywords = {Elderly,fall,injurious fall,nursing home,physical restraint,psychotropic medications},
 month = {5},
 publisher = {. Published by Elsevier Inc},
 day = {6},
 city = {Maria Wolff Foundation, Madrid, Spain.; BUPA-SLA Sanitas, Mayores, Spain.; BUPA-SLA Sanitas, Mayores, Spain.; BUPA-SLA Sanitas, Mayores, Spain.; BUPA-SLA Sanitas, Mayores, Spain.; Government of Navarra, Pamplona, Spain.; BUPA-SLA Sanitas, Mayores, Spain.;},
 id = {9e3610cb-d83c-36f8-b3a0-c700cb2afdf9},
 created = {2016-08-20T16:52:16.000Z},
 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 = {LR: 20160511; CI: Copyright (c) 2016; JID: 100893243; OTO: NOTNLM; 2016/03/11 [received]; 2016/03/14 [accepted]; aheadofprint},
 folder_uuids = {f424190b-df81-4929-b87f-d37bc272de00},
 private_publication = {false},
 abstract = {OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Physical restraints can almost completely be eliminated with reasonable levels of safety.},
 bibtype = {article},
 author = {Muniz, R and Gomez, S and Curto, D and Hernandez, R and Marco, B and Garcia, P and Tomas, J F and Olazaran, J},
 journal = {Journal of the American Medical Directors Association}
}