OBJECTIVE: The authors describe efforts to reduce use of mechanical restraints at a state psychiatric hospital. METHODS: Data were collected for individuals admitted to the acute adult unit (AAU) (N=2,910) and the community transition unit (CTU) (N=334) over three years. Two strategies aimed to reduce mechanical restraint use. First, staff were trained in deescalation techniques, and a response team was formed for crisis situations. Second, a policy change required prior approval for use of mechanical restraint. RESULTS: Mechanical restraint was significantly reduced on both units after the first strategy. After the second, additional reduction was noted on AAU (98% total reduction) but not on CTU, where the practice had already been eliminated. No increase in assaults or injuries was noted. CONCLUSIONS: Reduction in mechanical restraint use is possible through deescalation skills training, use of a response team, and policy changes. Strong leadership, staff buy-in, provision of feedback, and quality monitoring were also instrumental.
OBJECTIVE: The authors describe efforts to reduce use of mechanical restraints at a state psychiatric hospital. METHODS: Data were collected for individuals admitted to the acute adult unit (AAU) (N=2,910) and the community transition unit (CTU) (N=334) over three years. Two strategies aimed to reduce mechanical restraint use. First, staff were trained in deescalation techniques, and a response team was formed for crisis situations. Second, a policy change required prior approval for use of mechanical restraint. RESULTS: Mechanical restraint was significantly reduced on both units after the first strategy. After the second, additional reduction was noted on AAU (98% total reduction) but not on CTU, where the practice had already been eliminated. No increase in assaults or injuries was noted. CONCLUSIONS: Reduction in mechanical restraint use is possible through deescalation skills training, use of a response team, and policy changes. Strong leadership, staff buy-in, provision of feedback, and quality monitoring were also instrumental.