Reducing seclusion and restraints on the inpatient child and adolescent behavioral health unit: A quality improvement study

Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc
Amanda Eblin

Abstract

The utilization of seclusion and restraint during psychiatric inpatient treatment increases the risk of trauma, humiliation, physical injuries, psychological distress, and even death. Compared to adult patients, pediatric patients are more likely to be placed in seclusion and restraints. In a short-term child and adolescent behavioral health unit, the average seclusion and restraint rate was 0.031. The hospital's goal was to achieve a zero seclusion and restraint rate. The purpose of this project was to decrease the rate of seclusion and restraints at the study site. A quality improvement study was implemented based on a bundled intervention strategy. The intervention included a decision-making algorithm for initiation of seclusion and restraints, behavioral modification plans for patients at risk of seclusion and restraints, and a patient-debriefing tool to be used post a seclusion and restraint event. Post implementation, data were collected over a 3-month period. The implementation of a seclusion and restraint decision-making algorithm, behavioral modification, and patient debriefing successfully decreased the seclusion and restraint rate by 55% on an inpatient pediatric behavioral health unit. Although, the project resulted...Continue Reading

References

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Oct 4, 2008·Psychiatric Services : a Journal of the American Psychiatric Association·Lori Ashcraft, William Anthony
Jan 29, 2011·Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc·Muhammad Waqar AzeemRobert B Jones
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Citations

Jul 24, 2020·Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc·Patrick W RomaniJada Lister
Mar 28, 2021·The Journal of Pediatrics·Ashley A FosterJoel D Hudgins
Dec 1, 2021·Journal of Psychosocial Nursing and Mental Health Services·Emma Griffin

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