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This EBP project evaluated if in hospitalized adult patients on Sands 800 does the use of a restraint management bundle decrease the use of restraints during the inpatient admission compared to current restraint practices. In the SICU, restraint usage is an initial response instead of last intervention. This culture of care concerns nurses and providers. It was hypothesized that decrease restraint usage and time in restraints will allow the patient to remain safer by evaluating usage of restraint alternatives, cost savings, patient mobility, and clinical staff understanding of appropriate restraint usage.

The SICU was educated on the least restrictive device, which in this project was soft mitts. In-services and poster included the restraint wheel that provided alternatives to restraints. The team prioritized peer support and chart review. Restrained patients were reported to leadership daily with a focus on restraint use greater than 72 hours. Twice-daily audits verified orders and nursing documentation then were reported at shift change.

The RGH results showed 636 orders for non-violent restraint orders across 17 units with 96.7 average restraint time in hours June 1, 2023 to June 11, 2023. SICU restraint use decreased since the implementation of restraint education and restraint alternative wheel. Prior to implementation, 38 total patients restrained in March decreased to 28 restrained in August 2023. From the results, the hypotheses was supported. An increased availability of alternatives and types of alternatives as well as education for staff members would continue the culture change.

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Lindsey Alfred, RN; Kalani Dancoe, RN; Tawo Ewa, RN; Xiomara Figueroa, BSN, RN; Willow Finch, BSN, RN; Yusnavys Alfonso Flores, RN; Jessica Jones, RN; Kerry Lefebvre, RN; Beka Naylor, BSN, RN; Alyssa Umbrino, RN; Jarvis McGrath, BSN, RN, CNS; Elizabeth Duxbury, DNP, RN, CNS, CCRN, ACNS-BC

Rochester General Hospital, Rochester, NY

Restraint Free in 2023