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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:

  1. Train staff on Safeward (e.g., “Clear Mutual Expectations” policy).
  2. Pilot sensory tools in high-risk periods.
  3. 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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Answer
Safewards Change Management Assignment : Restraint Minimisation with Sensory Modulation in Mental Health Unit

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