Historical Sketch of a Unique Long Term Care Project:

The Pennsylvania Restraint Reduction Initiative (PARRI)

Officially launched at a kick-off event in Harrisburg on September 5, 1996, the Pennsylvania Restraint Reduction Initiative (PARRI) has been praised for providing leadership, direction, and technical support to hundreds of long term care providers throughout the Commonwealth. The state has seen a 87% drop in physical restraint use since the project's inception. In addition, the Initiative has developed 26 nursing home partners - facilities who are officially recognized as either physical restraint reduction, medication review or fall management training sites. To date, Initiative training sites have offered over 100 educational programs to area nursing homes. Funding for the project has come from the Intergovernmental Transfer Fund via the Commonwealth and the County Commissioner's Association.

To date, PARRI's four-member training team has provided assistance to over 93% of Pennsylvania's long-term care facilities. This free assistance includes consultation and on-site visits addressing the following areas: physical restraint reduction, fall prevention, communication, psychoactive medication reduction, behavior management, and individualized assessment. The team continues to provide support and technical assistance to any facility requesting assistance.

The training team facilitates numerous educational sessions throughout the state each year and has presented to audiences at national and state conferences. Topics include:

. A Sense of Belonging: Focusing on Resident/Nursing Assistant Interaction to Improve   Behavioral Outcomes

. Back to Basics: Strengthening Core Quality of Care Issues

. Bringing Together Fall Prevention and Restraint Elimination

. Can Falls Be Significantly Reduced in Long Term Care?: Issues and Strategies

. Communication Strategies for Dealing with Challenging Behaviors

. Diagnosing Danger: Examining Bed and Side Rail Entrapment

. Fall Management: Solutions for Fixing a Fractured Process

. Falls Got You Down?: Balancing Resident Autonomy and Safety

. Getting Back on Track: Realigning Your Bed and Side Rail Safety Program for Success

. History, Myths and Alternatives to Physical Restraints

. Keeping Restraints Off: Assessing the Falling Resident

. Physical Restraint Elimination: Alternatives, Strategies, and Interventions

. Physical Restraint Elimination: Bringing Families on Board

. Reducing Psychoactive Drug Use in the Nursing Home: Assessments and Interventions

. Side Rails: Don't Be Left in the Dark

. Unlocking the Mysteries of the Restraint-free Nursing Home

PARRI recently launched Pennsylvania's first fall management and prevention project called PA FIRST. (FIRST is an acronym for F all I nterventions R esources, S ystems, and T raining.) The project has been designed to address the increased need to develop a more comprehensive fall management and prevention policy and protocol. The PARRI staff is providing intensive support and technical assistance to selected sites. By year's end, these facilities will become training sites and offer educational programs on fall management/prevention strategies to area nursing home staff.

The Initiative published its first newsletter, PARRI News , in December, 2000. The bi-annual publication is mailed to all Pennsylvania long term care facilities. To view the latest newsletter, click here.   Or for more information about the PARRI, contact Kashmira Narinesingh-Smith at 610-335-1280  or by e-mail: kinfo@kendaloutreach.org.