Journal of Psychosocial Nursing and Mental Health Services
Vol. 47 No. 1 January 2009
By Sandra A. Barton, BSN, RN, BC; M. Rebecca Johnson, MS, RN; Lydia V. Price, MS, PMHCNS-BC
ABSTRACT
Restraint use in the treatment of mental illness has long been a controversial practice. Regulatory agencies, licensing organizations, and professional and advocacy groups have called for reduction of restraint use. Responding to this call for action, the leadership team of a behavioral health unit in a private, nonprofit community hospital evaluated reducing restraint use. Following training through the National Executive Training Institute of the National Association of State Mental Health Program Directors, a restraint-reduction project team was formed. Instead of reducing restraint use, it was decided to eliminate restraint use. Vision guided, the team developed an action plan. Culture change focused on the Mental Health Recovery Model and principles of trauma-informed care. Emphasizing person-centered care, this unit has now been restraint free for nearly 2 years. A surprise finding was that restraint elimination accompanied a decrease in use of “as needed” sedative-hypnotic medications. Person-centered care delivered by frontline staff led to culture change, a restraint-free environment, and less medication.
AUTHOR
Ms. Barton and Ms. Johnson are Clinical Managers, Behavioral Health Unit, Chambersburg Hospital, and Ms. Price is Clinical Nurse Specialist in Adult Psychiatric and Mental Health and Director of Patient Services and Behavioral Health, Summit Health/Chambersburg Hospital, Chambersburg, Pennsylvania.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
The authors thank the Behavioral Health Unit staff for their courageous undertaking, implementation, and ongoing dedication to this vision and change. The authors also thank Dr. Rajnikant Lad, Child and Adolescent Psychiatrist, for initial direction and support of the change project.
Address correspondence to Sandra A. Barton, BSN, RN, BC, Clinical Manager, Behavioral Health Unit, Chambersburg Hospital, 112 North Seventh Street, Chambersburg, PA 17201; e-mail: sbarton@summithealth.org.
