Hospitals in pursuit of excellence

Breaking the Restraints

After attending a 2005 conference on trauma-informed care, two nurses at Chambersburg (Pa.) Hospital returned emboldened to reduce the use of patient restraints. It is believed that these restraints cause psychiatric patients with abuse histories to revisit prior traumas and damage their road to recovery. But the unit's clinical leaders decided that restraint reduction was not an ambitious enough goal, and wanted to eliminate the use of restraints altogether, except as a last resort. The hospital's executive leadership endorsed the effort and gave permission to the unit to not restrain patients who destroyed property. The behavioral health unit took educational courses in relationship-based recovery practices, emphasizing dialogue with patients experiencing psychotic episodes. The hospital also transformed a seclusion room into a calming space with warm lighting and piped-in classical music. To date, the unit has not used restraints on a patient since January 2007. During that time period, the unit has also administered fewer sedative-hypnotic medications to patients.