Patient Restraints

Paper Summary:

This paper proposes a study to examine and assess the issues and problems associated with the implementation by acute care hospitals of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards for the use of patient restraints and to develop recommendations for appropriate strategies to be implemented by acute care hospitals in such implementation. The organizational setting for the proposed study is the Wellmont Health System which provides integrated health care through three acute care medical centers and hospitals located in Northeast Tennessee and Southwest Virginia.

Outline
Introductory Statement
Statement of the Problem
Research Questions
Purpose of the Study
Background on the Participating Institution
Overview of the Study
Review of Literature
Introduction
Theoretical Context
Resistance to Organizational Change
Techniques for Controlling the Change Process
Change Based in Strategic Planning
Input Analysis
Initiate Activities
Abolish Inertia
Review of Prior Research in the Use of Patient Restraints
Use of Restraints in Caring for Patients
Patient Perceptions of Seclusion
Effectiveness of Seculsion
Reducing Violence Without Seclusion
Staff Support for Seclusion Rooms
Patient Perceptions of the Seclusion Room Process
Methodology
Introduction
Research Design
Research Questions and Hypotheses
Variables and Operational Definitions
Population and Sample
Data Collection
Data Analysis
Methodological Limitations
Method Summary
Appendix A
Survey Questionnaire

From the Paper:

"Psychiatric mental health nurses frequently are required to care for patients who are acutely psychotic, aggressive, highly destructive, suicidal, or at risk of escape. Traditionally, "management strategies" for such patients have included the use of physical restraints, seclusion rooms, or constant one-to-one observation. These strategies have been criticized on grounds of ethics, economics, and efficacy (Montgomery & Johnson, 1996). The continued use of seclusion and restraint in psychiatric facilities "in the face of low confidence in such coercive interventions by health care professional may be a sign both of the persistence of traditional practices which have not been closely examined, as well as by the use of these traditional practices to shield the staff of such facilities against fear of mental illness, violence and loss of control" (Goren & Curtis, 1996, p. 7)."

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