I have never worked at a ltac facility, only at a hospital. Our hospital really pushes for us to not use restraints. We are to use them only as a last measure due to the risks with using restraints. Yes we still use them. Some pt's may have a 1:1 sitter and still be in restraints. What is the pt had gotten tangled and fell. You would still be filling out incident report and feeling guilty. It sounds like you did a good job checking on the pt and reorienting them but unfortunately that one short time span resulted in a fall. It takes a lot more effort to work with the pt so they don't have to be jn restraints. Some of the best nurses I know have had pts who fell. Management doesnt always see our efforts, they just see it as a fall. We try our best but we are just pulled in so many directions we cannot keep all falls from occurring. We have to get an order to use restraints but the nurse can terminate the restraints if she feels best such as when tubes/lines are removed. Do you guys have bed alarms? They have cut down on many falls from occurring at our facility. Don't feel bad just learn from this experience.