The nature and extent of physical restraint–related deaths in nursing homes: a systematic review

Objective: The aim of this study is to conduct a systematic review of the published research to examine the extent, nature, and risk factors of mortality due to physical restraint use. Method: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English describing mortality due to physical restraint in nursing home residents. Results: The combined searches yielded 2,016 records of which eight articles were eligible for inclusion. There were 174 deaths due to physical restraint in nursing home residents across the eight studies. Neck compression (n = 8) was the most common mechanism of harm resulting in death due to mechanical asphyxia. Conclusions: Physical restraint is associated with deaths in nursing home residents. Further research is needed to investigate alternative interventions to restraint use.