title: Reducing seclusion and restraint use in inpatient settings: a phenomenological study of state psychiatric hospital leader and staff experiences.
abstract: The current study explored and described the experiences of individuals who either directed or participated in successfully reducing the use of restraint and seclusion (R/S) in two inpatient public mental health hospitals. A phenomenological methodology was used to capture the lived experiences of 21 study participants, including senior leaders, middle managers, and direct care staff, who were interviewed as key informants. Thirty-two themes were extracted and subsequently synthesized into five "meaning themes." The five meaning themes yielded six significant findings: (a) critical roles of leadership and staff in successful R/S reduction projects; (b) ability of leaders and staff to change their beliefs and behaviors; (c) ability of leaders and staff to build a shared vision that was critical to the reduction of R/S use in in-patient settings; (d) identification and resolution of key challenges staff and leaders experienced in reduction efforts; (e) use of a solid performance improvement lens to direct changes in practices; and (f) important lessons learned.
authors.forename: Kevin Ann
authors.initials: KA
authors.lastname: Huckshorn
mesh_terms: D001291:Attitude of Health Personnel; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006783:Hospitals, State / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D007857:Leadership; D001523:Mental Disorders / Q000534:rehabilitation*; D010356:Patient Isolation / Q000523:psychology / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000523:psychology; D011568:Psychiatric Nursing / Q000379:methods; D012149:Restraint, Physical / Q000523:psychology / Q000706:statistics & numerical data*; D014754:Violence / Q000517:prevention & control / Q000523:psychology