Article first published online: 22 MAR 2007
Copyright © 2007 Wiley Periodicals, Inc.
Research in Nursing & Health
Volume 30, Issue 2, pages 131–140, April 2007
How to Cite
Wagner, L. M., Capezuti, E., Brush, B., Boltz, M., Renz, S. and Talerico, K. A. (2007), Description of an advanced practice nursing consultative model to reduce restrictive siderail use in nursing homes. Res. Nurs. Health, 30: 131–140. doi: 10.1002/nur.20185
An earlier version of this paper was presented at the Gerontological Society of America Conference, November 2003: Wagner, L.M., Capezuti, E., Boltz, M., Renz, S., & Talerico, K.A. Cost of environmental recommendations to reduce restrictive siderail use in nursing homes (Abstract). The Gerontologist, 43 (Special Issue, 1), 116.
This study was funded by John A Hartford Foundation; University of Pennsylvania Research Foundation; American Nurses' Foundation; John A Hartford Foundation Institute for Geriatric Nursing; University of Pennsylvania School of Medicine Alzheimer's Disease Center Core; NOVARTIS Foundation for Gerontological Research. The authors are grateful to research assistant Tara Williams, who collected the data; Betsy Weiss, for obtaining consents; and others who helped to code and enter the data: Honore Becker, BSN, RN; Gerald Driscoll, MSN, RN, CS; Kelly Wiltse, BSN, RN; and Diana Popa, BSN, RN. Special thanks to Dr. Christi Deaton, PhD, RN, and Jo Taylor, MPH, RN for their helpful ideas and comments on the early drafts of this paper.
- Issue published online: 22 MAR 2007
- Article first published online: 22 MAR 2007
- Manuscript Accepted: 14 NOV 2006
- advanced practice nurses;
- nursing homes;
- bed-related falls;
- physical restraints
Researchers have demonstrated that the use of physical restraints in nursing homes can be reduced, particularly where advanced practice nurses (APNs) are utilized. We examined the link between APN practice, siderail reduction, and the costs of siderail alternatives in 273 residents in four Philadelphia nursing homes. The majority of participants were cognitively and physically impaired with multiple co-morbidities. APNs recommended a total of 1,275 siderail-alternative interventions aimed at reducing fall risk. The median cost of siderail alternatives to prevent falls per resident was $135. Residents with a fall history experienced a significantly higher cost of recommendation compared to non-fallers. Findings suggest that an APN consultation model can effectively be implemented through comprehensive, individualized assessment without incurring substantial costs to the nursing home. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 131–140, 2007