Authors (including presenting author) :
Poon WM(1), Tam PY(1), Wu CN (1), Li NS (1), Tam KM(1)
Affiliation :
(1) Psychiatric in -patient service, Shatin Hospital
Introduction :
Physical restraint is a coercive intervention, which would cause plenty of dreadful implication to patient and staff such as injury, complaint, adverse experience. The training chair with sturdy structure has been adopted in psychiatric in-patient service of SH as early intervention to patients manifesting unsafe and coarse problematic behavior since 2021,which was supported by Quality & Safety(Q&S) Continuous Quality Improvement(CQI)funding. The design was further modified by nursing team and suggested to manufacturer for providing safer and less restrictive structure. The design of flip-up and flip-down side boards provides an adjustable level of stimulation and allows patient to maintain engagement with others. To the utmost, patient's dignity would be well preserved throughout the process. Patient were invited to opt the training chair as alternative to physical restraint for managing their agitation and emotion turbulence during early stage. The training chair not only facilitates the effectiveness of engagement but also optimizes continual de-escalation, which is critical to re-engaging therapeutic relationship and reducing the risk of further violent behavior.
Objectives :
(1) To promote person-centered care to patient and staff
(2) To promote patient and staff safety
(3) To decrease the use of physical restraint
Methodology :
A retrospective study of physical restraint data and Injury On duty records were employed. staffs' and patients' perspectives on the experience of using the training chair were collected with use of questionnaire by the end of 2022.
Result & Outcome :
Snapshot for users' feedback ( staff and patient) were collected in December. The two 4-points Likert-scale questionnaire were employed for reviewing ward staffs' and patients' experience towards the training chair. The lower marks indicated the more positive experience. The staff respond rate was 91% and they showed positive feedback in majority. 11 patients were invited to complete the questionnaires. Half of them preferred training chair to physical restraint because they could still engage in ward activities and choice of treatment option was respected. The percentage of using physical restraint was reduced by 53.3% in 2022 as compared with 2021. No injury related to use of the training chair was report.
