Recovery Model Implementation for a Medical/Geriatric Psychiatric Unit to Decrease Restraint and Seclusion Episodes:...

Area of Science:

• Psychiatric Nursing
• Quality Improvement
• Healthcare Management

Background:

• Physical restraint and seclusion are controversial behavioral management techniques in inpatient psychiatric settings.
• High rates of restraint use compared to national averages prompted a quality improvement initiative.
• The study addresses the need for evidence-based practices to improve patient care and reduce institutional costs.

Purpose of the Study:

• To decrease the use of physical restraint and seclusion in an inpatient behavioral health unit.
• To enhance the quality of care by implementing recovery model principles.
• To reduce healthcare costs associated with restraint and seclusion use.

Main Methods:

• A pre-post implementation design was utilized on a 14-bed medical/geriatric psychiatric unit.
• Interventions included staff education on the recovery model, RN language observation, and development of an orientation toolkit.
• Staff knowledge was assessed using the Recovery Knowledge Inventory, and restraint/seclusion use data were analyzed pre- and post-intervention.

Main Results:

• Staff knowledge of the recovery model improved by 6%–9% one week post-education, with sustained improvements in some domains.
• Restraint use decreased by 73.1% and seclusion use decreased by 16.3% post-implementation.
• While initial knowledge gains were observed, slight declines in two knowledge domains were noted at four months.

Conclusions:

• Implementation of recovery model principles is effective in reducing restraint and seclusion episodes in inpatient behavioral health settings.
• Adopting recovery-oriented care can lead to improved quality of patient care.
• Reducing restraint and seclusion use contributes to decreased organizational costs.