Date Available

4-11-2024

Year of Publication

2024

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Debra Hampton

Committee Member

Dr. Chizimuzo "Zim" Okoli

Co-Director of Graduate Studies

Dr. Marc Woods

Abstract

Background: The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. Although it is typically agreed that such measures should be used as a last resort in patient care, the majority of nurses feel that seclusion and restraint are necessary interventions in managing adverse behaviors of mental illness. There is a lack of data examining front-line nurses’ and providers’ knowledge, practices, and attitudes toward the use of seclusion and restraint following the use of a targeted educational training.

Purpose: This project aimed to evaluate the impact of a web-based educational intervention on the knowledge, practices, and attitudes of front-line nurses and providers concerning the use of seclusion and restraint among front-line nurses and providers in an inpatient psychiatric hospital. Additionally, the project sought to assess for changes in seclusion and restraint usage rates post-implementation of the web-based educational intervention.

Methods: A quasi-experimental design with a pre- and post-test evaluation was utilized to assess the impact of targeted education on knowledge, practices, and attitudes towards the use of seclusion and restraint. A brief, 20-minute education module was administered to participants following the pre-test. The post-test was administered immediately following the education module assessing for changes. Changes in knowledge, practices, and attitudes were assessed using paired t-tests with a p value of .05.

Results: Attitude regarding the use of seclusion and restraints post-education, including a greater willingness to acknowledge patients' rights and the emotional impact of seclusion and restraint use, improved to a significant level. Increases were observed in the comprehension of appropriate seclusion and restraint practices and the effects of staffing levels on seclusion and restraint utilization. Decreases were observed in hospital-wide seclusion and restraint rates, with reductions noted in both seclusion and restraint rates across most individual units.

Conclusion: This project demonstrated the positive impact of targeted educational interventions on enhancing knowledge and impacting attitudes toward seclusion and restraint use practices among healthcare nurses and providers. The substantial decrease in hospital-wide seclusion and restraint rates post-implementation underscores the effectiveness of the intervention in promoting patient-centered care and reducing the reliance on restrictive interventions.

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