Reducing the Use of Mechanical Restraints in the Medical-Surgical Department

J Am Psychiatr Nurses Assoc. 2023 Jan-Feb;29(1):38-44. doi: 10.1177/1078390320987622. Epub 2021 Jan 15.

Abstract

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.

Keywords: mechanical restraints; mental health; psychiatric; reducing restraints; restraints use.

Publication types

  • Review

MeSH terms

  • Hospitals, Psychiatric*
  • Humans
  • Mental Health
  • Quality Improvement
  • Restraint, Physical*
  • Retrospective Studies