Date of Graduation

Winter 12-16-2022

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Psychiatric Mental Health Nurse Practitioner

First Advisor

Dr. Trinette Radasa

Second Advisor

Dr. Elena Capella

Abstract

Background: Despite global shifts in behavioral health treatment, changes regarding use of seclusion and restraint (S/R) continues to be extremely slow. Local Problem: Increasing S/R events and subsequent staff injuries and financial burden. Methods: A quality improvement project providing education in trauma-informed care (TIC), sensory modulation (SM), and S/R debriefing (S/RD). Interventions: Education and training for S/RD, TIC, and SM using a variety of materials and methods over a 6 to 12-month period was provided to staff within a 16-bed inpatient adult psychiatric health facility (PHF) and a crisis stabilization unit (CSU). Because of positively affecting the use of S/R, utilizing evidence-based practices, the values of providing a culture of respect, dignity, and social responsibility align with the values of the University of San Francisco’s Jesuit tradition (University of San Francisco, n.d.). Measures: Project outcomes were assessed by pre- and post-project surveys (N=90), and S/R events and S/R debriefing comparisons. Regression analysis was used to test for intervention effect on TIC understanding and S/RD. Results: No significantly strong evidence was provided for the intervention [t987.1)=0.29, p=0.98). Increases were noted in SM understanding, and staff desire for a SM room. Conclusion: Multiple studies indicate education in TIC, SM, and S/RD present a viable avenue for decreasing S/R events. In our study, multiple confounds such as fluid leadership, staffing, project delays, and global events were strong contributors to outcomes; indicating further study is warranted in these areas. Keywords: seclusion, restraint, interventions, trauma informed care education, adult, inpatient, education, psychiatric, SM, debriefing

Included in

Nursing Commons

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