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Reducing the Use of Mechanical Restraints in the Medical-Surgical Department
1Oluwakemi Bamidele Adekanmi, DNP, BSN, RN, PMHN-BC, Regions Hospital, St. Paul, MN, USA.
Background:
The most crucial discussion in psychiatric hospitals is the safety of patients, especially during incidents that have the potential to cause physical harm such as those where mechanical restraints are used.
Aim:
The goal of the project was to reduce the use of mechanical restraints by 25% within 10 weeks in two piloted medical-surgical units.
Method:
A total of 60 articles were examined for relevance; out of these, the author used 30 studies that were based on observational, literature review, quantitative analysis, or clinical trial methodologies to conduct a comprehensive literature review. The author used a retrospective and descriptive design of chart review data collection to implement the project. The six core strategies framework, coupled with the creation of mental health championship role, was implemented to mitigate the problem.
Results:
This study shows that the implementation of the six core strategies and the role of a mental health champion helped reduce the use of mechanical restraints by 100%.
Conclusion:
A total of 3,072 patients' charts were reviewed in which there were three PERT (Psychiatric Emergency Response Team) activation and no mechanical restraint events, which showed a considerable quality improvement compared to the pre-implementation data collection of 37 PERT and 14 mechanical restraint events. The implications for practice and further study in the field are the involvement of more authors with similar expertise, the use of a control group for comparison, and a longer length of study duration.
Insights
Implementing a six core strategies framework and a mental health champion role significantly reduced mechanical restraint use in psychiatric hospitals. This initiative achieved a 100% reduction in restraint events, enhancing patient safety.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety in Psychiatry
- Clinical Intervention Strategies
Background:
- Patient safety is paramount in psychiatric hospitals, particularly concerning incidents involving mechanical restraints.
- Reducing the use of mechanical restraints is a critical objective for improving care quality.
Approach:
- A comprehensive literature review of 30 studies informed the project design.
- A retrospective chart review methodology was employed for data collection.
- Implementation involved a six core strategies framework and a dedicated mental health champion role.
Key Points:
- The project aimed to decrease mechanical restraint use by 25% in 10 weeks across two medical-surgical units.
- A total of 3,072 patient charts were reviewed.
- The intervention resulted in a 100% reduction in mechanical restraint events.
Conclusions:
- The combined approach of the six core strategies and mental health champion role proved highly effective.
- Significant quality improvement was observed, with zero mechanical restraint events post-implementation.
- Future research should consider control groups and extended study durations for broader validation.
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