Percentage of long-term care home residents in daily physical restraints over the last 7 days

Percentage of long-term care home residents who were physically restrained on a daily basis

Percentage

The indicator is calculated using four rolling quarters of data by summing the number of residents that meet the inclusion criteria for the target quarter and each of the previous three fiscal quarters. This is done for both the numerator and denominator. The unadjusted value is the quotient of the summed numerator divided by the summed denominator, multiplied by 100 to get the percentage.

Number of long-term care home residents in the denominator who were recorded as having been physically restrained daily on their Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0 target assessment

Inclusions:

(P4c = 2) OR (P4d = 2) OR (P4e = 2)

Where,

P4c = Trunk restraint [0,1,2]

P4d = Limb restraint [0,1,2]

P4e = Chair prevents rising [0,1,2]

0 = not used

1 = used less than daily

2 = used daily

Number of long-term care home residents in a fiscal quarter with a valid RAI-MDS 2.0 assessment

Inclusions:

To be considered valid, the resident assessment must: 

• Be the latest assessment in the quarter 
• Be carried out more than 92 days after the admission date
• Not be a RAI-MDS 2.0 Admission Full Assessment

Exclusions:

1. Residents who were comatose (B1 = 1)
2. Residents who were quadriplegic (I1bb = 1)

This indicator can be risk adjusted through direct standardization using the Activities of Daily Living (ADL) Long Form, which includes bed mobility, transfer, locomotion, dressing, eating, toileting and personal hygiene self-performance.

Continuing Care Reporting System (CCRS)

Canadian Institute for Health Information (CIHI)

Institution, Province, Region, Time

A physical restraint is any manual method, or any physical mechanical device, material or equipment that is attached or adjacent to the resident's body, that the resident cannot remove easily, and that restricts the resident's freedom of movement or normal access to his or her body. It is the effect the device has on the resident that classifies it into the category of restraint, not the name or label given to the device, nor the purpose or intent of the device. This definition is different from that of the definition for physical restraint used by the Ministry of Long-Term Care (MLTC), where intent plays an important role. This indicator does not measure the use of bed rails or chemical restraints (i.e. medication). The results for this indicator include only residents in long-stay beds. Rolling four quarter averages stabilize the rates from quarter-to-quarter variations, especially for smaller facilities, but make it more difficult to detect quarterly changes. Since residents are assessed on a quarterly basis, each resident can contribute to the indicator up to four times. Risk-adjusted values are censored if the denominator is less than 30. General limitations when using RAI-MDS 2.0 data include random error, coding errors and missing values. There may be some inconsistencies in how long-term care homes code restraints due to the difference in the definition of physical restraints between the RAI-MDS 2.0 and the Ministry-legislated definition. General limitations when using RAI-MDS 2.0 data include random error, coding errors and missing values. The COVID-19 pandemic affected many long-term care homes across Ontario, including their ability to complete assessments and/or submit data. Available data may vary by jurisdiction and facility. Results should be interpreted in the context of the COVID-19 pandemic.

A physical restraint is any manual method, or any physical mechanical device, material or equipment that is attached or adjacent to the resident's body, that the resident cannot remove easily, and that restricts the resident’s freedom of movement or normal access to his or her body. It is the effect the device has on the resident that classifies it into the category of restraint, not the name or label given to the device, nor the purpose or intent of the device. This definition is different from that of the definition for physical restraint used by the Ministry of Health and Long-Term Care, where intent plays an important role. The restraint use items capture restraint use in the seven days prior to the target assessment. Data are based on information from the mandatory Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0 assessment. The RAI-MDS 2.0 is a standardized assessment that is completed for each resident upon admission to a long-term care home and quarterly thereafter, by the resident’s care team, by reviewing the resident’s medical records and speaking to the resident and their family. Legacy agency Health Quality Ontario (HQO) used an evidence-informed process and expert panel, composed of Ontario-based long-term care home operators, clinicians and researchers, to produce Ontario benchmarks that represent good resident outcomes and high-quality care. The benchmark for this indicator was set at 3% by an expert panel through a modified Delphi process (2012 & 2015). Alongside public reporting performance indicators, benchmarks are an important tool for supporting long-term care homes and sector stakeholders in tracking progress, setting priorities or targets, and learning from homes that are excelling.

06/10/2025 10:57:00