Ifeoma Dunn
University of Michigan Flint, USA
Title: Improving Patient Care by Utilizing an Evidenced-based Education to Reduce Seclusion
Biography
Biography: Ifeoma Dunn
Abstract
The need to promote the safety of nurses and patients cannot be overemphasized. The use of seclusion as a measure to manage aggression is increasing in psychiatric units and does not promote safety. The use of seclusion is controversial and has been deemed an encroachment on human right and dignity which can cause psychological trauma, physical injury, deterioration of illness, long hospitalization stay, increase readmission rate and death. This quality improvement project utilized a quasi-experimental design for the project. The project employed the TeamSTEPPS evidenced-based program to help inform nurses about verbal de-escalation which helps to reduce seclusion and patients aggressive behavior. The research utilized a quantitative method to collect data pre- and post-test. Data analysis applied a descriptive analysis method to assess each individual variable and an ANOVA analysis to determine if there was a change in each of the primary outcomes variables from pre (January to February 2018) to post (February to March 2019). The targeted population for provider was the day and night shift full time registered nurses (N=35) and the patients targeted population was patients admitted on the unit over 4 months period estimated to be (N=98). The desired outcome was a change in nurses’ behavior from the usage of seclusion to utilizing verbal de-escalation to reduce seclusion that was seen in seclusion track log and a decrease in patients’ aggressive behavior as seen in patients’ charts. The findings of the study showed that there was statistically significant reductions in both seclusion usage (35% decrease, 11.5 ±0.5 versus 7.5±0.5, df=1, 36, p< .001) and the number of aggressive patients (42% reduction, 34.1±4.5 vs. 20.1±3.5, F=279.0, df=1, 95, p< .001) per month during the post-test period as compared to the pretest-period. The only variable that was significantly associated with the improvements was the educational intervention. The results of this study underscore the importance of training psychiatric nurses on verbal-de-escalation in efforts to reduce seclusion usage and patients’ aggressive behavior in psychiatric settings. Thus, promoting patient safety as well as a safe work environment for nurses which is paramount.