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September 19, 2012

Physical Restraint Use in Nursing Homes

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Division of Psychogeriatric Medicine, Psychiatric University Hospital Zurich, Zurich, Switzerland (florian.riese@bli.uzh.ch).

JAMA. 2012;308(11):1091-1092. doi:10.1001/jama.2012.9400

To the Editor: Dr Köpke and colleagues1 demonstrated that an educational, multicomponent intervention reduced the use of physical restraints for nursing home residents without a concomitant increase in falls or use of psychotropic medication. The cost of the intervention was only about $1000 per nursing home and did not require an increase in nursing staff. This is supported by a recent study2 from Germany showing no significant relationship between use of physical restraints and the ratio of patients to trained staff. Unfortunately, the intervention was not successful in reducing daytime bed restraint with a waist belt, which was the least frequent but arguably the most invasive form of restraint under study. Future interventional studies should specifically target this form of restraint.