Date of Graduation

Winter 12-16-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Psychiatric Mental Health Nurse Practitioner

First Advisor

Dr. Trinette Radasa

Second Advisor

Dr. Elena Capella


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