Predictors of Physical Restraint Use in Hospitalized Veterans at End of Life in the Acute Care Setting: An Analysis of Data from the BEACON Trial (TH318-C)

Abstract

Objectives Gain an understanding of the prevalence of restraint use in dying patients. Understand what patient characteristics and care processes place a patient at greater risk for being restrained at time of death. Original Research Background: The use of physical restraints in dying patients should be limited to situations where patient death is unanticipated. Little is known about the prevalence or risk factors for restraint use at end of life. Research Objectives: To determine the prevalence and predictors of physical restraint use at the time of death in hospitalized adults. Design: conducted between 2005 and 2011. Setting/Participants: Data on the last seven days of life were abstracted from the medical records of 5,476 decedents from six Veterans Administration Medical Centers (VAMCs) in the southeast United States and from VA administrative databases. Methods: Based on literature and expert clinical opinion, we prospectively identified potential risk factors for restraint use at the time of death from among all variables collected during the trial. Factors included location of death, medications given, nasogastric tube, intravenous (IV) fluids infusing, family presence at time of death, and receipt of a palliative care consultation.