The importance of reducing the use of psychiatric-mental health mechanical restraints has been the focus of clinical nursing practice. A hospital with two psychiatric-mental health units has demonstrated a sustained success related to reducing mechanical restraints. In this qualitative case study, nurses were interviewed to understand how the reduction of mechanical restraints on the psychiatric-mental health units impacts the practice culture and the perception of the psychiatric nurses toward a mechanical restraint-free practice. This study provided new knowledge related to evidence from the psychiatric-mental health nursing practice, themes of barriers, and facilitators toward a restraint-free practice. The participants describe the complexity of the nursing role, how the decision to use restraints is complex, the first hand experience of the nurse who was a part of the leather restraint process, that moving the restraints off the units did not make a difference, that the removal of the restraints from the building was not supported by the nurses. The barrier themes are current practice, medication, and patient acuity or behavior. The facilitator themes are philosophy, CPI implementation, practice or culture change, and medication. This is an innovative study on a restraint-free practice. The recommendations stem from the new information obtained from the evidence and themes and include further inquiry into the passion of nurses to avoid restraint, understanding personal style as well as interaction and bias, environmental alterations, and theme-based recommendations. The evidence and themes provide nursing and nursing leadership knowledge for application to other facilities that are considering a restraint-free environment.
|School:||University of Phoenix|
|School Location:||United States -- Arizona|
|Source:||DAI-B 76/10(E), Dissertation Abstracts International|
|Subjects:||Mental health, Behavioral psychology, Nursing|
|Keywords:||De-escalation, Mechanical restraints, Restraint reduction, Restraint-free, Restraint-free practice, Restraints|
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