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Relationship of Less Restrictive Interventions with Seclusion/Restraints Usage, Average Years of Psychiatric Experience, and Staff Mix

Northern Virginia Mental Health Institute in Falls Church, Virginia

Rachel E. Myers, RN, CDE, MSN

Northern Virginia Mental Health Institute in Falls Church, Virginia

BACKGROUND: Seclusion and/or restraints (S/R) usage is a legal, moral, and ethical issue of patient rights and safety. Current emphasis is on using lesser restrictive interventions (LRI) in crisis management.

OBJECTIVE: This descriptive/correlational study examined the relationship of LRI with S/R usage, average years of psychiatric experience of nursing staff, and staff mix.

STUDY DESIGN: The sample included 82 events requiring crisis intervention. Data were collected at a state mental health facility using a crisis cycle intervention tool and staff questionnaire.

RESULTS: Data revealed a significant relationship between LRI and S/R usage and a significant positive relationship between percentage of licensed nurses and LRI. However, the relationship between average years of psychiatric experience and LRI was not significant. Fourteen percent of LRI could be predicted by percentage of licensed staff.

CONCLUSION: The findings supported using LRI in crisis management. Using LRI individualized to the crisis event promotes a safer, more therapeutic environment for both parties and staff. The findings revealed the need to evaluate the impact of a change in staff mix on quality of care and desired outcomes. Further research is needed to explore the multiple variables that influence LRI.

Journal of the American Psychiatric Nurses Association, Vol. 7, No. 5, 139-144 (2001)
DOI: 10.1067/mpn.2001.118178


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