Author Biographical Info

Chiamaka Nwadike is a Registered Nurse currently pursuing a Doctor of Nursing Practice (DNP) with a focus on Mental Health. She aims to contribute to the advancement of behavioral health practices through evidence-based approaches.

Date of Doctor of Nursing Practice Project Completion

Spring 5-12-2025

Faculty Advisor

GOERING LADAWNA

Abstract

Purpose: This quality improvement project aims to (1) decrease time in restraint use on the inpatient psychiatric unit through implementing the restraint chair protocol, and (2) improve staff satisfaction in using safety restraint.

Background: In acute psychiatric care, restraints are used to ensure safety, but they pose physical and psychological risks. There is an increasing recognition of the need for patient safety, including the use of de-escalation techniques that prioritize restraint chairs over bed restraints to ensure safety.

Methodology: The project follows the Plan-Do-Study-Act (PDSA) model, which supports a continuous improvement approach to implementing the restraint chair algorithm and evaluating restraint interventions. These include creating a safety restraint algorithm, which involves teaching and reviewing the current protocol, including de-escalation techniques. The most significant interventions include staff training on using the safety chair and comparing restraint use before and after.

Results: The project achieved a 4.89% reduction in total restraint hours after implementation. The survey results showed that staff respondents reported increased satisfaction with de-escalation techniques, with 85% of staff feeling greater satisfaction in dealing with aggressive behavior.

Implications: These findings suggest that the Safety Restraint Chair algorithm and de-escalation techniques may help reduce the use of restraints. However, the study had limitations, including a short follow-up period. Future efforts should focus on ongoing training and long-term sustainability to improve patient care in psychiatric settings.

Keywords: reducing restraints, restraint protocol, de-escalation, acute psychiatric unit, safety restraint chair

Keywords

reducing restraints, restraint protocol, de-escalation, acute psychiatric unit, safety restraint chair

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