Implementation of a Sensory Room in a Psychiatric Intensive Care Unit: A Mixed-Methods Study

Abstract

Sensory rooms provide a safe space for consumers in inpatient psychiatric settings to self-manage distress and agitation and potentially reduce the use of restrictive practices. However, sensory rooms are often not available, and there is limited knowledge about strategies that support the implementation. This study explored consumer and clinician experiences of a sensory room in an acute psychiatric intensive care unit (PICU) and examined its impacts on restrictive practice use (seclusion and Pro re nata [PRN] medication). A mixed-methods approach was employed in the analysis of interviews with consumers and clinicians and routinely collected data pertaining to restrictive practice use. Themes were generated from the qualitative data through deductive analysis against the Theoretical Domain Framework (TDF) and COM-B to understand the barriers and facilitators to use. Rates of PRN use and seclusion were calculated for three 2-month periods: prior to the implementation of the room and two time points following implementation. Prominent barriers related to limited opportunity to use the room due to the environmental context (room location) and resources (staffing). Facilitators were clustered around consumer and staff motivation to use the room. There were no significant changes in PRN use over time, and while there was a numeric decrease in the use of seclusion, this did not reach statistical significance. In summary, sensory rooms were valued by consumers and most staff and were considered to provide a safe therapeutic space within the often chaotic and complex treatment environment of a PICU. Strategies for successful implementation are discussed.