Marquis Rehabilitation & Nursing Center

Realizing their score on the Restraints quality measure was worse than the state and national average, Marquis Rehabilitation and Nursing Center took an interdisciplinary team approach to identifying the cause of the issue. Administration committed the entire organization to the goal of reducing the use of restraints. Their interdisciplinary team includes: Administrator, Admissions department, Medical Director, Physicians, Nurses, Certified Nursing Assistants, Social Services Department, Recreation Department, Physical and Occupational Therapy Departments, Dietary Services and Reception. The team identified that Marquis had a policy of automatically utilizing physical restraints after a resident fell.

Staff education on the risk of injuries due to physical restraints and evidence based guidelines on reducing restraints was provided. Each restrained resident was reassessed by the interdisciplinary team, reviewing their complete medical history, current medications review and specific issues that led to the use of the restraint. Restraint reduction trails were initiated on the unit. The unit team employed for each resident, as appropriate,  PT/OT evaluation, nursing rehab programs, hourly observation, diversional activities, bed bolsters, low beds, psychiatric and/or psychological evaluation and a toileting schedule.

They changed their policies and procedures to ensure that their care team assesses each resident before, upon and after admission in order to ensure the safety of the residents.  

Ongoing education is provided to facility staff to maintain the restraint-free environment they have established.