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

Our aim at reducing seclusion and restraint started as a Department of Nursing quality indicator. The administration then made this program a hospital goal. Administrators and managers monitor this information daily and share it with various hospital quality improvement committees for review and subsequent practice changes. Although clinical settings may have slightly different definitions or approaches when addressing prevention, crisis intervention, and treatment, it is important to assess, reassess, and evaluate these patients at every step throughout the treatment process. We have found that the above interventions were successful in producing a major reduction in the use of restrictive interventions. The use of restraints does not help patients learn to manage their anger but only serves to control people and cause an immediate division between those seeking help and those who offer it. When patients are treated as people, with dignity and respect, they are less likely to become aggressive. As clinical settings strive to meet this challenge and eliminate the option of using these highly restrictive and sometimes punitive measures, ongoing administrative and clinical support in collaboration with patients, advocates, and others is essential. It is only through this means that traditional high-risk hands-on techniques will be replaced with new and innovative methods making the transition from ineffective outdated interventions to an effective best practice model.