Sensory Reduction on the General Milieu of a High-Acuity Inpatient Psychiatric Unit to Prevent Use of Physical Restraints: A Successful Open Quality Improvement Trial.
| Autor: | Yakov S; 1 Svetlana Yakov, MD, University of Alabama at Birmingham, AL, USA., Birur B; 2 Badari Birur, MD, University of Alabama at Birmingham, AL, USA., Bearden MF; 3 Melissa F. Bearden, MACN, OT/L, University of Alabama at Birmingham, AL, USA., Aguilar B; 4 Barbara Aguilar, BSN-BC, RN, University of Alabama at Birmingham, AL, USA., Ghelani KJ; 5 Kinjal J. Ghelani, MD, University of Alabama at Birmingham, AL, USA., Fargason RE; 6 Rachel E. Fargason, MD, University of Alabama at Birmingham, AL, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of the American Psychiatric Nurses Association [J Am Psychiatr Nurses Assoc] 2018 Mar/Apr; Vol. 24 (2), pp. 133-144. Date of Electronic Publication: 2017 Oct 17. |
| DOI: | 10.1177/1078390317736136 |
| Abstrakt: | Background: Impaired sensory gating in patients with acute mental illness predisposes to overstimulation and behavioral dyscontrol. Objective: Explore use of sensory reduction interventions on a high-acuity inpatient milieu to reduce high assault/restraint rates. Design: A multidisciplinary team using failure mode and effect analysis to explore high restraint use between 4:00 p.m. and 7:00 p.m. observed patient/staff overstimulation contributed to behavioral escalations. The team implemented sensory reduction/integration improvements over a 5-month period to prevent excessive restraint use. Results: Restraint rates dropped immediately following light and sound reduction interventions and by 72% at 11 months postimplementation. Mann-Whitney statistics for unpaired 6-month comparisons, 1-year pre- and postintervention showed significant reductions: Assault rates (median pre = 1.37, post = 0.18, U = 4, p = .02); Restraint rates (median pre = 0.50, post = 0.06, U = 0, p = .002). Conclusion: Sensory reduction during a high-stress time period on a high-acuity psychiatric unit was associated with a reduction in assaults and restraints. |
| Databáze: | MEDLINE |
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