University | University of Auckland (UOA) |
Subject | Nursing |
Reducing Restraints in Mental Health: Implementing Safeward & Sensory Modulation
Name: [Your Name] | Student ID: [Your ID]
Problem/Situation
In the past 12 months, the Adult Acute Inpatient Mental Health Unit recorded 118 restraint incidents (56.7% male, 43.3% female), primarily affecting patients aged 20–49 (79%). Key concerns:
- Restraint Types: Full personal (37), partial (34), seclusion (18), locked doors (29).
- Reasons: Harm to others (49), self-harm (32), treatment facilitation (20).
- Gaps in De-escalation: Only 11.7% had restraint-minimisation plans; interventions like sensory modulation (0%), cultural support (0%), and family involvement (0%) were underutilized.
SMART Goal
“Reduce physical restraints by 30% in 6 months by implementing Safeward principles (e.g., clear mutual expectations, calming strategies) and sensory modulation tools (weighted blankets, dim lighting), supported by staff training and patient feedback.”
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Situational Analysis (SWOT)
Strengths | Weaknesses |
---|---|
High staff awareness of restraint risks | Lack of training in Safeward/sensory tools |
Existing low-stimulus rooms (used 7.6%) | No cultural/family interventions documented |
Opportunities | Threats |
Sensory tools are low-cost and effective | Resistance to change from staff |
Safeward model reduces conflict | Time/resources for training |
Key Data Snapshot
![Pie chart: Restraint Types – Full personal (31%), Partial (29%), Seclusion (15%), Locked doors (25%)]
Top Missing Interventions:
- Sensory modulation (0%)
- Cultural support (0%)
- Family involvement (0%)
Reflection & Next Steps
Findings: Restraints are overused due to reliance on reactive measures (security presence: 16.3%) vs. proactive strategies (sensory tools: 0%).
Learnings: Safeward principles and sensory modulation can address root causes (e.g., distress, overstimulation).
Action Plan:
- Train staff on Safeward (e.g., “Clear Mutual Expectations” policy).
- Pilot sensory tools in high-risk periods.
- Audit restraint incidents monthly.
Opposing Forces: Staff inertia, budget constraints.
Supportive Forces: Evidence from Safeward trials (60% restraint reduction in similar units).
Visuals to Include:
- Bar graph: “Reasons for Restraint” (harm to others, self-harm, etc.).
- Icons: Safeward principles (e.g., teamwork, calm space).
Formatting Notes:
- Headings: Bold, large font.
- White Space: Balance text with visuals.
- Font: Arial 11pt for body, 14pt for headings.
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