Physical Restraint and Seclusion as Nursing Issues

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Introduction

Restraint and seclusion are often considered a failure of nurses to provide quality care for the patients (Kontio et al., 2012). This is why an evidence-based proposal for additional nursing training was created. However, it touches upon a variety of aspects that may be financial, quality, and clinical in nature. This paper will show how the proposed evidence-based practice project impacts each of those aspects.

Financial Aspect

Every project that involves additional training requires financing from the hospital administration. Depending on the type of training, the time needed to complete it, its scale and other factors, the needed monetary resources may vary. The proposed solution would require a hospital-wide training program focused on specific issues present in the current nursing practice. This program may be seen as costly in the short-term. However, it may save money for the hospital in the long-term. By improving the level of care in the hospital and reducing the instances of restraint and seclusion, the hospital is guaranteed to be better protected against malpractice lawsuits. The positive public opinion of the hospital is also likely to attract more patients seeking quality care.

Quality Aspect

The proposed evidence-based project is specifically designed to improve the quality of care in the hospital. It would touch upon the development of empathy among the nurses so that they would have a greater awareness of the needs of the patients. The quality of care is expected to rise as a whole due to the previous research conducted in similar environments. By improving the quality of care in the hospital, the number of positive outcomes for the patients is expected to rise dramatically (Muir-Cochrane, Baird, & McCann, 2015). While the main focus of the project is on the reduction of the need for restraint and seclusion, the proposed training is aimed at improvement of quality care in the hospital as a whole.

Clinical Aspect

The clinical practice of the hospital is expected to be impacted by the proposal in that more time would be dedicated to the needs of the patients. Common issues such as the development of pressure ulcers may be given additional attention as an additional benefit of the project. Nevertheless, the main focus of training is on the reduction of restraint and seclusion of patients. As it was discussed previously, this type of clinical practice may be highly traumatic to the patients and in some cases may have a negative effect on the stress levels of nurses as well (Wieman, Camacho-Gonsalves, Huckshorn, & Leff, 2014). By focusing on providing clinical care for the needs of the patients, this practice is expected to be used only in the most critical situations.

Conclusion

The proposed evidence-based project is expected to require financial backing by the administration of the hospital, improve the quality of care, and reduce the use of restraint and seclusion in the clinical practice. It touches upon each of the aspects and is set to have benefits for all of them. By improving the level of empathy that the nurses experience toward their patients, the training program is expected to have a highly positive effect on the hospital as a whole, even outside the use of restraint and seclusion. The evidence-based nature of the proposal should provide credibility to these claims, and the two-step structure of the project would make sure to address the specific issues the hospital experiences.

References

Kontio, R., Joffe, G., Putkonen, H., Kuosmanen, L., Hane, K., Holi, M., & Välimäki, M. (2012). Seclusion and restraint in psychiatry: Patients experiences and practical suggestions on how to improve practices and use alternatives. Perspectives in Psychiatric Care, 48(1), 16-24.

Muir-Cochrane, E. C., Baird, J., & McCann, T. V. (2015). Nurses experiences of restraint and seclusion use in shortstay acute old age psychiatry inpatient units: A qualitative study. Journal of Psychiatric and Mental Health Nursing, 22(2), 109-115.

Wieman, D. A., Camacho-Gonsalves, T., Huckshorn, K. A., & Leff, S. (2014). Multisite study of an evidence-based practice to reduce seclusion and restraint in psychiatric inpatient facilities. Psychiatric Services, 65(3), 345-351.

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