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Restraint use higher in non-metro facilities


Aged care residents in regional and remote facilities are more likely to be physically restrained than their city-dwelling counterparts, the first report of the government’s now mandatory program on quality indicators shows.

There were 25,101 recorded occasions of intentional physical restraint of residents across Australia in the July-September quarter under the National Aged Care Mandatory Quality Indicator Program, which became compulsory on 1 July.

In the same period there were 63,217 recorded occasions of physical restraint devices, such as bedrails, chairs with locked tables, seatbelts, safety vests and shackles, in use to intentionally or otherwise restrain the care recipient.

That equates to 1.57 occasions of intentional restraint and 3.95 occasions of restraint devices per 1,000 recipient days, which refers to the number of resident-days a commonwealth subsidy was lodged.

However the rates of occasion in regional and remote areas were higher for both intentional restraint (1.79) and restraint devices (4.30) than in major cities (1.49 and 3.86 respectively), the data published by the Australian Institute of Health and Welfare on Monday shows.

Looking around the country restraint use was the highest in Western Australia (3.15) followed by Queensland (3.09), the Northern Territory (2.23), New South Wales (1.33), the ACT (1.32), Tasmania (1.01), South Australia (0.98) and Victoria, which record the lowest use (0.61).

Intentional physical restraint across the country. Data from AIHW

Under the quality indicators program, residential aged care providers must collect and report data three times a day once a month on physical restraints, pressure injuries and unplanned weight loss.

Around 90 per cent (2,500) of aged care facilities that were required to submitted the information on time, the AIHW said.

During the quarter, 11,803 aged care recipients experienced significant unplanned weight loss, which is three or more kilograms in three months and 12,177 residents recorded unplanned weight loss, which is a loss of any amount every month for three months.

Instances of pressure injuries

Pressure injuries in residential aged care. Data from AIHW

Almost 85 per cent of the 13,306 pressure injuries recorded in the first quarter were stage 1 or stage 2 injuries, which are the two least severe categories, the AIHW data and above table shows.

Pressure injuries are categorised by the following six stages:

  • Stage 1: non-blanchable erythema of intact skin
  • Stage 2: partial-thickness skin loss with exposed dermis
  • Stage 3: full-thickness skin loss
  • Stage 4: full-thickness loss of skin and tissue
  • Unstagable: obscured full-thickness skin and tissue loss
  • Suspected deep tissue: persistent non-blanchable deep red, maroon or purple discolouration.

There were more stage one pressure injuries recorded in regional and remote areas (0.40 injuries per 1,000 recipient days) than in major cities (0.34), however, the data was same or similar across remoteness for the other stages.

Providers are required to submit data for the October – December quarter by 21 January 2020.

Forthcoming quality indicators

The Department of Health has enlisted PricewaterhouseCoopers (PwC) to help it develop new quality indicators for falls and fractures and medication management, which will be added to the program from July 2021.

Providers can register their interest to participate in a pilot of the new quality indicators here.

View the published quality indicators data here.

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3 Responses to Restraint use higher in non-metro facilities

  1. Patrick December 18, 2019 at 4:43 pm #

    Hello,

    The data from the AIHW is broken up by state and detail for metro and non-metro is not provided. How do you draw the conclusion that “aged care residents in regional and remote facilities are more likely to be physically restrained than their city-dwelling counterparts”?

  2. Natasha Egan December 19, 2019 at 8:27 am #

    Hi Patrick,

    The AIHW report shows this breakdown towards the bottom of its interactive report under the heading:
    Residential aged care quality indicators, by use of physical restraint sub-indicators, and remoteness, July to September 2019
    See https://www.gen-agedcaredata.gov.au/topics/Quality-in-aged-care/Explore-quality-indicators
    Cheers,
    Natasha

  3. Patrick December 19, 2019 at 12:16 pm #

    Ah ha! Thanks, I overlooked that you had to change the radio-button option to change the data. It seems that almost all the results are worse in regional and remote areas.

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