Restraint-free facility?

[reussir1]

My facility is making the change to restraint-free. Does anyone here work for one? I don't know how well we will do without side rails/lap buddies/etc will work, but our facility said if they fall then they can be put in therapy because they will be able to get a lot more $$$ per resident....

[KimberlyRN89, BSN, RN]

My facility is restraint free. It is an assisted living facility however. The nursing home I work at has restraints & for residents who are fall risks/combative, I think they are a necessity. As for the assisted living facility: I wish we had restraints such as seatbelts, chair alarms,etc. We have the highest fall rate in our company district:uhoh3: We average about 30 falls a month..Management just blames us however & says that we should catch the residents if they are falling.

Yea, I'm totally gonna catch a 300lb resident & stop them from falling! /sarc

[reussir1]

That's what we were told too...catch them. It is really difficult with 5 CNA'S and 85 residents though.

[yousoldtheworld]

Every facility I've worked in since the first one has been restraint free. My current facility has seatbelts on wheelchairs because they are severely developmentally disabled kids (they have no control over their bodies for the most part, they could just fall out of the chair, etc), but no restraints. Be prepared to have more falls, and being told "Well, you have to watch her!" despite the fact that you have a billion other people to take care of, too.

[CoffeemateCNA]

Sometimes I hate working a restraint-free facility.

I miss Lap Buddies the same way hippies miss being able to smoke pot in public.

We have SOOO many falls that could easily be prevented if a Lap Buddy or seatbelt were in place. Just last night, I was sitting and fantasizing about restraints as I struggled to keep 5 residents in their wheelchairs, all of whom seemed to think they were still able to walk.

[reussir1]

Are side rails also forbidden in your facilities? That's one of the big things I'm worrying about...

[yousoldtheworld]

Yes. Siderails are only allowed if the resident or his/her family requests them, except in the cases of the two kids we have who sleep in cribs.

Luckily, no one has fallen out of bed...yet.

[topher-67]

The LTC I work in is "restraint-free" with the exception of a few Dr. ordered & family requested side rails. The previous facility I worked at had lap buddies, etc. and we had only one person in 120 days fall out of a wheelchair. Where I am now we have a resident fall at least once every 36-48 hours! But, I'm told the residents have a right to be restraint free and a right to fall down as well. Our flooring isn't made of rubber so when they hit, look out! We have chair alarms and the tethered alarms on some, but it only takes a second. Thank God nobody has had any serious injury from hitting the deck......yet. :uhoh21:

[fuzzywuzzy, CNA]

Do the beds have side rails at all? What about when you're rolling somebody over? Half my residents would freak out if there were no rails. They hold onto them when rolling over, use them to reposition themselves, and hang all their stuff over them.

[DolceVita, ADN, BSN, RN]

but our facility said if they fall then they can be put in therapy because they will be able to get a lot more $$$ per resident....

Someone in charge actually gave that to you, the staff, as a rationale?

[JDZ344]

Where I work is restraint free, with the exception of bed rails (although the amount of paperwork to do to put those up is crazy!).

I don't really have anything to compare it to, as we have never used restraints. but I do know that we quite often get patients come in with a hx of falling in hospital and breaking legs and hips.

[yousoldtheworld]

Do the beds have side rails at all? What about when you're rolling somebody over? Half my residents would freak out if there were no rails. They hold onto them when rolling over, use them to reposition themselves, and hang all their stuff over them.

Ours do not. We have two residents who have siderails (at the request of their families) and two that are in cribs. Some of the others have bolsters (kind of cushions that go under the sheets to help keep them from falling out), but no siderails on anyone else.