Summary of the Area of Interest and Significance to Nursing Practice

I am a Psych Nurse and my area of interest is psychiatry whose concern is mental health. Psychiatry is a field of medicine that specializes in training professionals on how to diagnose, treat and care for people with mental health problems (American Psychiatric Association, 2018). I am currently in school to be Psychiatric Nurse Practitioner. I have a passion to help psychiatric patients live their best lives. My current community has a shortage of community facilities for psych patients to continue their treatments after their stay at a psych hospital. The use of restraints and seclusion is a common approach to caring psychiatric and substance abuse patients (Substance Abuse and Mental Health Services Administration (SAMHSA), 2015). It is a psychiatric related topic that guides the problem formulation explained in the following sections. Therefore, the topic of focus entails reducing the use of restraints and seclusion for inpatient psychiatric and substance abuse patients in a psych hospital.

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The use of restraints and seclusion for psychiatric patients has been a problem that has achieved little or no solution in the community. The approach of restraints and seclusion has resulted to negative effects to the patients including increased trauma and death when used for an extended period (Berzlanovich, Schopfer, & Keil, 2012). The persistence of the problem and effects of restraints and seclusion in my community has drawn my attention to seeking an alternative. The introduction and implementation of an alternative to restraints and seclusion will minimize the use of the traumatizing method of care for psychiatric patients after their stay in the psychiatric hospital.

The topic of reducing restraints and seclusion in caring for psychiatric and substance abuse patients is significant to nursing practice since nurses are aimed at making patient have the best experience when under their care. Eliminating seclusion and restraint practices for nurses will be a step towards achieving a violent, accident-free care to the patients. The nursing practice is guided by the philosophy of promoting wellness and resilience and increasing the chances of recovery (Jacob, 2015). Therefore, the topic supports the intention of the nursing practice in caring for patients.

Research Questions

Generation of the questions that the study will be answering based on the research problem was guided by the target population and the intended objectives or outcomes to be achieved at the end of the investigation. Therefore, the following questions are relevant to the problem area.

• Do restraints and seclusion increase the costs of care for psychiatric and substance abuse patients?
• How has restraints and seclusion affected families and psychiatric patients in psychiatric hospitals?
• Are there available alternatives to restraints and seclusion in caring for psychiatric and substance abuse patients?
• In what ways can the use of restraints and seclusion be reduced when caring for psychiatric and substance abuse patients from psychiatric hospitals?
• What benefits can patients gain from the use of the alternatives to restraints and seclusion?

The above questions were analyzed for feasibility based on the problem to be solved. The issue under investigation seeks to find ways of reducing the use of restrains and seclusion as an intervention for psychiatric and substance abuse patients. Therefore, it is important for the researcher to understand or explain why restraints and seclusion need to be minimized in psychiatric hospitals. Further, it is crucial to connect with the costs and effect to families and psychiatric patients due to with using restraints and seclusion. The alternatives to restraints and seclusion are anticipated to provide better patient outcomes.

Preliminary PICOT Question and PICOT Variables

PICOT Question

For psychiatric and substance abuse patients, individualized occupational therapy programs are effective for improved patient care and savings on costs when compared to restraints and seclusion facilities for the first six months after being discharged from the psych hospital.

PICOT Variables

P - Psychiatric and substance abuse patients - this group of patients is important and relevant to the question since they form the focus of the question of research. The psychiatric and substance abuse patients will form the target population where the researcher will select a sample for collecting data. The information from these patients will answer the research question for the study

I - Individualized occupational therapy programs - this is an intervention, the main variable to be tested in the research. The aim is to provide improved results of patient care when compared to the control group

C - Restraints and seclusion - this is the control variable that will explain the difference in patient outcome when the intervention is used. Using the control variable in the study, it will be possible for the researcher to identify the outcome of the patients where the individualized occupational therapy programs have been used when compared to the use of restraints and seclusion.

O - Improved patient care and cost savings - these are the anticipated outcomes of using the intervention of individualized occupational therapy programs for psychiatric and substance abuse patients.

T - The first 6 months after discharge from a psych hospital - This is the anticipated time of evaluating the differences in patient outcomes when the intervention and the control variable are used as methods of care to the population.

Ten Possible Keywords

The ten possible keyword that will be used when conducting a literature search for the PICOT question include restraints and seclusion, restraints for psychiatric patients, seclusion, restraints, seclusion for mental health patients, alternatives to restraints and seclusion, reduce seclusion and restraints, preventing restraint and seclusion, physical restraint in mental health, ethics of restraint in mental health, and complications of non-voluntary seclusion. These keywords were selected as they are anticipated to provide the researcher with direct information on the topic. They are directly linked to the topic area and there is a high possibility of providing a relevant literature review.

References

American Psychiatric Association. (2018). What Is psychiatry? Retrieved from https://www.psychiatry.org/patients-families/what-is-psychiatry

Berzlanovich, A., Schopfer, J., & Keil, W. (2012). Deaths Due to Physical Restraint. Deutsches Arzteblatt International, 109(3), 27-32.

Jacob, K. (2015). Recovery Model of Mental Illness: A Complementary Approach to Psychiatric Care. Indian Journal of Psychological Medicine, 37(2), 117-119.

SAMHSA. (2015). Alternatives to seclusion and restraint. Trauma and Violence. Retrieved from https://www.samhsa.gov/trauma-violence/seclusion