Abstract
Objectives
The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. This pilot evaluation project assessed the impact of a web-based educational intervention on the knowledge, practices, and attitudes of front-line nurses concerning seclusion and restraints and on the actual use of restraints and seclusion in an inpatient psychiatric hospital setting.
Methods
A quasi-experimental, pre- and post-assessment design was used to evaluate the impact of a 20-min targeted education intervention on knowledge, practices, and attitudes toward the use of seclusion and restraint among 40 psychiatric-mental health providers.
Results
Attitudes regarding the use of seclusion and restraints, including a greater willingness to acknowledge patients’ rights and the emotional impact of seclusion and restraint use significantly improved post-educational intervention. Improvements were also observed in the comprehension of appropriate seclusion and restraint practices and the effects of staffing levels on seclusion and restraint utilization. Hospitalwide seclusion rates decreased by 35%, and restraint rates post-educational intervention decreased by 58%.
Conclusion
This pilot evaluation study demonstrated that targeted education significantly improved attitudes and practices related to seclusion and restraint among psychiatric-mental health nurses and providers. Mean attitude scores increased from 32.7 to 36.8 post-intervention (p = .002), and mean practice scores improved from 33.9 to 35.2 post-intervention (p = .004). The decrease in hospitalwide seclusion and restraint rates post-intervention indicates the intervention could be effective for reducing the reliance on restrictive interventions.
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