Abstract

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.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3708852; ProQuest document ID: 1692072252. The author still retains copyright.

Author Details

Suzanne Barnum Goetz, PhD, MSN, RN, CNE

Sigma Membership

Zeta Theta at-Large

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Qualitative Research

Keywords:

Restraint-Free Practice, Mechanical Restraints, Psychiatric Care, Restraint Use Reduction

Advisor

Fran Nelson

Second Advisor

Lilia Santiague

Third Advisor

Marilyn Miller

Degree

PhD

Degree Grantor

University of Phoenix

Degree Year

2014

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2021-10-11

Full Text of Presentation

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