Debi Damas

Restraint reporting leads to increase in antipsychotic use

Blog Post created by Debi Damas Support on Mar 21, 2014

Interesting statistics from a study at the University of Chicago and University of Pennsylvania that encompassed nursing homes in California, Florida, Illinois, New York, Ohio and Texas (about 1/5 of all nursing home residents).


This study found a strong correlation to publicly reporting restraint use and the increase in antipsychotic use between 2002 and 2005.   The authors of the study noted that there may have been an unintended consequence of reporting that link efforts to improve care through reporting may have the effect of decreasing overall quality of care.  The authors compared this to "teaching to the test" where, in the education system, instructors focus on areas likely to appear on standardized tests, therefore not really providing a broader education experience.


Given this information, do you think this is what may have lead to the initiative to decrease the percentages of anti-psychotic use in those persons with dementia.


How do your antipsychotic numbers look?  Do you have processes in place to determine if medications are unnecessary or inappropriate to treat the resident's medical symptoms?  Remember, dementia is not a proper diagnosis to use antipsychotics.


Is your QAPI program in in place to ensure all aspects of resident care, problematic or not, are in place to "nip in the bud" any potential problems that may start creeping up on you?


Here is a link to the article in McKnights where this information appeared:  Public reporting of physical restraint use led to 36% increase in antipsychotic prescribing for dementia, researchers fi…