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Standardized Protocol for Sensory Room Use on an Inpatient Child Psychiatry Unit

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2023-05
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Problem: The American Psychiatric Nurses Association recommends that psychiatric facilities reduce restraint and seclusion use, with a goal of elimination. The inpatient child psychiatry unit at a freestanding pediatric hospital has not met this goal. From January to April 2022, there were six seclusions and three physical holds. Purpose: The purpose of this quality improvement initiative is to implement a standardized protocol for sensory modulation room use to decrease restraint and medication use. Methods: A multidisciplinary team developed a protocol for the sensory room. All nursing and child psychiatry specialist staff employed on the child psychiatry unit were trained on the standardized sensory room protocol. Data was collected regarding staff comfortability of sensory room implementation, rate of sensory room use by eligible patients, rate of as-needed medication use, and restraint and seclusion use after sensory room utilization. Results: 100% of staff were trained on how to utilize the sensory room. There was a 60% adherence to the use of the sensory room for eligible patients. A total of 6 seclusions were documented after the start of implementation, a 50% increase from 12 weeks prior to implementation. There were no significant trends in either seclusion use, or sensory room use. Conclusions: Further investigation should be done to analyze the effectiveness of a sensory room as an alternative to chemical or physical restraints. Adequate staffing and patient acuity was noted to be the biggest barrier in adherence to the sensory room protocol. Diagnoses such as autism and anxiety may benefit from the room more than other psychiatric disorders.

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