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Related Experiment Videos

Least restrictive alternatives: do they really work?

I Richmond1, D Trujillo, J Schmelzer

  • 1Department of Medicine, VA Western New York Health Care System, Buffalo, USA.

Journal of Nursing Care Quality
|October 1, 1996
PubMed
Summary

This study highlights effective alternatives to seclusion and restraint in psychiatric care, significantly reducing their use. Implementing these least restrictive interventions improved patient outcomes and decreased overall treatment hours.

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Area of Science:

  • Psychiatric Nursing
  • Quality Improvement Science
  • Patient Safety

Background:

  • Seclusion and restraint are common psychiatric treatments with ongoing ethical and therapeutic debates.
  • Effective alternatives and staff training are crucial for reducing seclusion and restraint use.
  • Patient outcomes and safety are paramount in psychiatric care settings.

Purpose of the Study:

  • To identify and evaluate alternatives to seclusion and restraint in a long-term psychiatric facility.
  • To assess the impact of these alternatives on seclusion and restraint rates.
  • To inform quality improvement initiatives in psychiatric nursing.

Main Methods:

  • A quality improvement study was conducted in a long-term care psychiatric facility.
  • Data on disruptive behaviors and interventions were collected.

Related Experiment Videos

  • Least restrictive alternatives were implemented and their effect on seclusion and restraint rates was analyzed.

    • Main Results:

    • 773 incidents of disruptive behavior were managed without seclusion or restraint.
    • One-to-one verbal intervention followed by PRN medication was the most frequent alternative.
    • Total seclusion and restraint hours decreased by 31%, with restraint hours alone dropping by 47%.

    Conclusions:

    • Least restrictive alternatives are effective in reducing seclusion and restraint use in psychiatric settings.
    • Staff training and consistent implementation of alternatives are key to successful reduction.
    • This approach enhances patient safety and improves the quality of psychiatric care.