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Reducing patient restraints: a pilot approach using clinical case review.
Michael J Sclafani1, Frederick J Humphrey, Sharon Repko
1University of Medicine and Dentistry of New Jersey, Newark, NJ, USA. tsclafani@patmedia.net
Perspectives in Psychiatric Care
|January 8, 2008
Summary
A specialized team successfully eliminated patient restraints by implementing a novel consultation approach. This strategy improved unit climate and care for individuals with developmental disabilities and mental illness.
Area of Science:
- Psychiatry
- Developmental Disabilities
- Mental Health Care
Background:
- Restraint use in specialized units presents challenges.
- Nontraditional approaches are needed to improve patient care and safety.
- Developmental disabilities and mental illness often co-occur, requiring integrated treatment.
Purpose of the Study:
- To decrease the incidence of physical restraints in a specialized care unit.
- To implement and evaluate a university-based consultation process for patient care.
- To analyze treatment interventions, milieu conditions, and staff interactions.
Main Methods:
- A university-based team provided consultations focusing on patient interventions and milieu.
- Data collection included treatment strategies, environmental factors, and staff interactions.
- The study targeted a specialized unit for patients with developmental disabilities and mental illness.
Main Results:
- Restraint episodes decreased from 36 per month to zero.
- Significant positive changes were observed in the unit's climate.
- Care approaches were notably altered on the specialized unit.
Conclusions:
- A team-based approach with a specific intervention plan can effectively reduce restraint use.
- Implementing a nontraditional consultation process can transform unit dynamics.
- This model offers a viable strategy for improving care in specialized psychiatric settings.
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