Striving toward a best practice model for a restraint-free environment

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Behavioral Health Management

Background:

• Seclusion and restraint are restrictive interventions used in clinical settings.
• Reducing the use of these measures is a critical quality indicator and hospital goal.
• Effective patient management requires continuous assessment and evaluation.

Purpose of the Study:

• To significantly decrease the application of seclusion and restraint.
• To implement and evaluate alternative strategies for managing aggressive patient behaviors.
• To transition from traditional, high-risk interventions to evidence-based best practices.

Main Methods:

• Initiated a quality improvement program focused on reducing seclusion and restraint.
• Established daily monitoring of restrictive intervention use by administrators and managers.
• Integrated findings into hospital quality improvement committees for practice changes.

Main Results:

• Achieved a major reduction in the use of restrictive interventions.
• Demonstrated that patient-centered care, dignity, and respect decrease aggression.
• Highlighted the ineffectiveness of restraints in anger management and therapeutic relationships.

Conclusions:

• Collaborative administrative and clinical support is essential for eliminating restrictive measures.
• Patient dignity and respect are fundamental to de-escalating aggression.
• Transitioning to innovative, non-punitive methods is crucial for effective patient care models.