Physical Restraint Reduction

For years, physical restraints have been used as an intervention to prevent falls, to manage wandering and/or behavioral disturbances, or to minimize tampering with medical devices (intravenous lines, feeding tubes, indwelling bladder catheters, etc.).

However, recent research has demonstrated that restraints do not prevent falls. In fact, people who are restrained still fall, and are more likely to be seriously injured if the fall occurs while restrained. And other methods for managing wandering, behavioral issues and interference with medical devices have been found to be more effective.

Physical restraints should only be used in rare circumstances, and only as a short-term measure. Using a restraint should be the last resort, even when a justifiable medical indication is present.

Close attention to the person's comfort, safety and needs for hydration, elimination, exercise, and social interaction is essential while the restraint is in use.

Resources Created by HHSC

• Evidence-Based Best Practices: Physical Restraints (PDF) provides an overview of the best practice recommendations for physical restraint use, reduction and elimination.

Resources from Other Organizations

• Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes is a guide for providing quality care to people with dementia, including recommendations for providing care without the use of physical restraints.
• Tools: Physical Restraints (PDF) includes information about basic assessment, assessment tools, falls, behavior problems, wandering and medical necessity.
• Restraint Toolkit helps nursing home staff with restraint reduction efforts. Note: You must complete the free registration to access the information on this website.
• Promoting Safety: Alternative Approaches to the Use of Restraints is a best practice guideline developed by the Registered Nurses’ Association of Ontario. It provides evidence-based recommendations for the care of people who are at risk for being restrained.