Nurses' Perceptions of Engaging With Patients to Reduce Restrictive Practices in an Inpatient Psychiatric Unit.

Abstract

Despite the evidence of harmful effects of restrictive practices on patients and nurses, restrictive practices are still commonly used in the inpatient psychiatric settings. There has been a paradigm shift of a collaborative approach and implementation of patient engagement to reduce the use of restrictive practices. The purpose of this study was to explore nurses' perceptions of engaging with patients to reduce the use of restrictive practices in an inpatient psychiatric unit. This qualitative-descriptive study was conducted on an inpatient psychiatric unit of a large university hospital in Canada. Semistructured individual interviews were conducted with 6 nurses in 2016. Data generated by the interviews were coded and analyzed by thematic analysis. Four major themes emerged from the data analysis: unit engagement practices, managing the escalation by engaging with patient, engaging during the use of restrictive practices, and factors influencing engaging with patient to reduce restrictive practices. It is concluded that nurses perceive engaging with patients as possible and effective to reduce the use of restrictive practices despite identified barriers.