Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Adelstein, Katharine

Committee Member

Abusalem, Said

Author's Keywords

restraints; restraint; seclusion; psychiatric nursing; DASA screening tool; alternative measures; mental health; inpatient psychiatric unit


Restraints are widely used on inpatient psychiatric units when psychiatric patients exhibit escalating behaviors. Physical restraints, including seclusion, increase patients’ risk for injury and psychological trauma. Acute inpatient psychiatric units should aim to use restraints only as a last resort and for as little time as possible to keep the patient and others safe. The literature suggests that ways to decrease restraint rates on inpatient psychiatric units include risk assessment for early identification and proper use of alternative measures. Nursing staff education has been proven to play an important role in decreasing overall restraint times on inpatient psychiatric units. The focus of this project was implementing an education program for nursing staff on a medical-psychiatric unit at University of Louisville Hospital. The outcomes observed from this quality improvement project included improved nursing knowledge, evidenced by an increase in post-test scores after the educational session (P