Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Gross

Abstract

Evidence from research around the world have indicated that the use of restraints and seclusion has become a controversial issue in mental health facilities relating to managing patients' aggressive behaviors. Evidence indicates that all other options should be used first and the use of restraints and seclusions should be used as a last resort when all other options have failed. The rationale is to bring about awareness of all of the options or alternative interventions that are available other than the use of restraints and seclusions, as research has indicated that restraints and seclusions provide no therapeutic value to the patient or mental health staff. The conceptual framework is based on the Tidal model, which focuses on empowering the mental health patient with the tools and resources to make a change and addressing their self-behaviors. This model also provides the foundation for the patient's growth. The conceptual framework also includes the Precede-Proceed model, which focuses on voluntary change and not forced change. This model indicates that a voluntary change will last longer and have more positive outcomes than a forced change. The research question is, will the use of therapeutic options decrease or eliminate the use of restraints and seclusions? This was a mixed method design using both quantitative and qualitative data. The qualitative data was based on the options that were used prior to restraint use. The quantitative data was based on a percentage value to all options from 100% for the most used option to 0% to option not used. It is recommended that all available options be used first prior to restraint and seclusion use because the options provide a therapeutic value for both the patient and staff member. Also, the use of the options does not interfere with the patient staff relationship.

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