Date on Paper

8-2023

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Clark, Rudy

Committee Member

Schirmer, Sarah

Author's Keywords

mental health; adolescents; retraumatization; sensory room education; seclusion and restraints; quality improvement

Abstract

Seclusion and restraints are intended to be used as a last resort intervention if a patient presents as harmful to themself or others. However, the use of seclusion and restraints in mental health practice has been questioned for several decades. A 26-year study that researched restraint-related fatalities among children and adolescents in the United States from 1993 to 2018 disclosed 79 deaths (Nunno et al., 2022). Seclusion and restraints also restrict autonomy which can cause retraumatization if a patient was previously neglected or abused (Hammer et al., 2011). Many patients presenting to the project site are survivors of neglect and abuse and, therefore, at risk for retraumatization. Distressing long-term effects of seclusion and restraints include self-stigmatization, painful memories, and post-traumatic stress disorder (PTSD) symptoms (Steinert et al., 2013). Nursing staff must implement alternative strategies to seclusion and restraints to reduce the likelihood that children seeking care in acute psychiatric settings will experience these distressing long-term effects. One alternative found in the literature is sensory rooms. The purpose of this project was to increase the staff’s knowledge and confidence when implementing a sensory room to promote healing among adolescent patients. Unit staff were provided education regarding sensory room use before the sensory room was implemented by the facility. Pre-questionnaires were utilized before education was offered. The same questionnaires were completed once the sensory room had been implemented and staff began utilizing learned knowledge to determine if there was noted improvement in staff’s ratings after education. Seclusion and restraint data was collected on the participating unit. The goal of this evidence-based educational project was to increase staff confidence and knowledge and decrease episodes of restraints and seclusion.

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