Initiatives to minimise inappropriate use of restraint

These initiatives aim to reduce the inappropriate use of physical and chemical restraint in residential aged care.

Minimising restraint initiatives include:

  • strengthening laws that apply to residential aged care providers on restraint use
  • changes to the Pharmaceutical Benefits Scheme (PBS) risperidone listing
  • awareness raising activities regarding the appropriate use of antipsychotics and benzodiazepines in residential aged care
  • workforce initiatives

An Aged Care Clinical Advisory Committee was also set up in January 2019 to advise on ways to reduce inappropriate use of chemical restraint in residential aged care.

Why this is important

Aged care homes are required to provide safe and quality care to residents.

Reducing the inappropriate use of physical and chemical restraint is part of providing quality care.

The goals of the initiatives

Regulatory and non-regulatory initiatives are planned or in place to reduce inappropriate use of restraint.

These initiatives aim to help people in these groups understand their responsibilities and change behaviours, where needed:

  • approved providers of residential aged care
  • prescribers working in residential aged care, including GPs, specialists and nurse practitioners
  • pharmacists
  • nurses and personal care workers
  • aged care residents’ families and decision makers

How we will meet these goals

To drive reform and minimise the inappropriate use of restraint in residential aged care, we need:

  • regulatory and compliance measures
  • cultural change
  • effective clinical governance

Outcomes

A number of initiatives are working in complement to achieve change.

Laws on minimising restraint

Residential aged care providers have specific responsibilities that relate to the use of physical and chemical restraint. These responsibilities are in the Quality of Care Principles.

The Aged Care Quality and Safety Commission has more information to support providers.

Further strengthening of the legislation

The Quality of Care Amendment (Reviewing Restraints Principles) Principles 2019 came into effect on 29 November 2019. The legislation now:

  • makes it clear restraint must always be used as a last resort
  • refers to state and territory legislation for prescribers’ responsibilities regarding informed consent
  • requires a 12-month review of the restraint regulation operations to ensure they are minimising the use of inappropriate restraint

Funding for better safety, quality and integrity

In response to the Royal Commission’s Interim Report, the Government allocated additional funding to improve safety, quality and integrity of aged care services.

The funding includes:

Changes to the Pharmaceutical Benefits Scheme (PBS)

The PBS risperidone listing has changed to include a telephone authority code for repeat prescriptions. Read more in the risperidone fact sheet.

Policy makers will also better understand prescribing behaviours, with unique residential aged care service identifiers to be collected in the PBS data.

Prescribing psychotropics in residential aged care

We are raising awareness and providing information on prescribing psychotropics in residential aged care.

See information and resources for prescribers.

Education and training

We are developing educational messaging about proper use of antipsychotic medications and benzodiazepines in residential aged care for:

  • pharmacists
  • nurses and personal care workers
  • approved providers of residential aged care services
  • families and decision makers

Workforce initiatives also include:

  • professional development for doctors and nurses
  • train‑the‑trainer programs for nurses and personal care workers
  • nurse champions in residential aged care

Embedded pharmacists in residential aged care homes

From February 2020, a trial of embedded pharmacists will be expanded to all residential aged care services in the Australian Capital Territory (ACT).

Who we work with on the initiatives

The Aged Care Quality and Safety Commission may assess approved providers’ use of restraint under the Aged Care Quality Standards.

The Commission’s Better Use of Medication in Aged Care Project is also currently focusing on psychotropic medicines used in aged care.

An Aged Care Clinical Advisory Committee advises on many of the initiatives to reduce use of restraint.

Related information

On 1 November 2019, Commonwealth, state and territory Health ministers agreed to recognise ‘quality use of medicines and medicines safety’ as a national health priority.

This promotes:

  • the safe, quality use of medicines
  • appropriate medication management in residential aged care

The Aged Care Quality and Safety Commission has:

Resources

Guiding principles for medication management in residential aged care facilities

These guiding principles promote the safe, quality use of medicines and medication management in your aged care home. They are based on evidence and advice from experts, providers and users of medicines in health and aged care services.

Contacts

Dementia Australia

Dementia Australia is the national peak body for people of all ages living with all forms of dementia, and their families and carers.

View contact

Minimising inappropriate use of restraint contact

Email us if you have questions or want more information about minimising inappropriate use of restraint in aged care.

ACCAC [at] health.gov.au

View contact

Last updated: 
12 February 2020
Tags: