Evidence Based Practice Implementation in Mental Health Facilities

Considering that physical restrain tend to be used on patients in psychiatric clinics to reduce agitation and aggression, there is need to incorporate evidence-based practice in such situations. The research aims to determine the most appropriate method to ensure safety among patients in the psychiatric facilities. The focus of the research is on McLean Mental Hospital evaluating the possibility of full implementation of EBP. It explores the challenges, especially regarding funding, and the inability to get enough staff to enroll for the program. The research intends to answer the question of whether the use of physical restraints on patients admitted to a psychiatric hospital compared to positive and proactive care prevents danger to self (patient) and others (peers) during problematic behavior.

Although the facility is receiving support from the local and federal government, there is a huge deficit in the budget making the EBP projects lag behind. The other barrier is the experience level of some staff to participate in the EBP. Lack of skills and adequate support from some staff has prohibited urgent adoption of the EBP hospital-wide. The Facilitators The key facilitators of the EBP within the facility include the growing need for a facility for the treatment of the mental health issues among the local patients. The project is patients-centered and the presence of a collaborative team of nurses and physicians has facilitated the organization’s readiness. wiley. com, 2017). One method used to ensure safety in psychiatric clinics is the use of physical restraints.

According to Ncbi. nlm. service. gov. uk, 2014). Positive and Proactive Care aims at improving care, accountability, assurance, and leadership. It entails not deliberately restraining patients in a manner that impact their breathing, face, and so forth. Objective, Purpose, and Justification of the Research The research aims to determine the most appropriate method to ensure safety among the patients in the psychiatric facilities. To do so, the research will compare two methods namely; the use of physical restraints and the Positive and Proactive care. By determining which method is more effective, this will add to the knowledge in regard to mentally ill safety in the psychiatric facilities. Addressing the issue on patient safety is an important issue to hospitals. Considering that the Centers for Disease Control and Prevention invests a large amount of money on the issue and still there is a deficiency in regard to patient safety in psychiatric facilities.

58, which ranges from 25-52 years. These nurses had at least 7 months and at most 29 years. The sampling method was appropriate.  Participants were selected via purposive sampling. Data was collected using semi-structured interviews and continuously processed until the desired theme was established.  Literature used was essential in describing the subject matter. The literature helped to establish the fundamentals regarding physical restrain. These are restraint as a multi-purpose procedure, restraint as a challenging subject, processing of physical restraint, and the effects of restraint on the spectrum.  Each of these categories proves the validity of the research conducted. Through them, the study has established that physical restrain is still a standard procedure in psychiatry. gov. uk. Positive and Proactive Care: reducing the need for restrictive interventions Validity  The research was based at the Royal College of Nursing.

Interested participants were given the opportunity to vote for supportive consultation. Notably, more than 95% of the participants voted in favor of supportive consultation.  My patients and their families will be supported as they understand that restrictive intervention may cause delayed recovery including physical and psychological trauma, more so to people who experience the procedure directly. ​ Resource 3: Onlinelibrary. wiley. com. Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Despite these challenges, the long-held perception regarding the mentally ill has been legitimized by the operationalization of safety value. The research incorporated varied sources like Goffman’s 1961 Asylums and Foucault’s 1965 Madness and Civilization. These texts are rich in information about the background of stigmatization and societal attitudes including reactions to mental illnesses.

Goffman and Foucault's offer theoretical viewpoints regarding the legitimization of practices commonly used to promote safety and risk management in psychiatric nursing practice. Goffman’s work is crucial in establishing how social institutions such as jails, mental hospitals or concentration camps deter people from connecting to the outside world.   I would use the results in practice in order to discourage the fear associated with working in a mental hospital. Section D: EVIDENCE BASED PRACTICE PROPOSAL. (SOLUTION DESCRIPTION) Proposed Solution Implementation of evidence-based practice in mental health facilities is essential in the promotion of health and improvement of health outcomes. The physical restraint has been widely used in psychiatric facility. The use of mechanical devices to restrain patients is inhuman and need to be replaced with more proactive solutions (Khan et al, 2017).

Considering that the hospital is having huge financial deficits in its plan to implement EBP, the use of proactive approach will improve the quality of care and ensure safety of both patients and health care practitioners. Expected Outcomes If a more proactive method is adopted, the hospital would see a huge reduction in aggression in its mental facility. The facility will also have an Method to Achieve Outcomes Positive and Proactive Care will be used to minimize the need for restrictive intervention by providing information and practice guidance to the healthcare practitioners who work to support the patients. Positive and Proactive Care aims at improving care, accountability, assurance, and leadership. It entails not deliberately restraining patients in a manner that impact their breathing, face, and so forth.

Investing resources in one stage at a time reduces resistance, prevents relapse, and facilitates development. The TTM ensures increased participation of the target population in the change process since it attracts the whole population including those who are not willing to take actions. The various stages are described as follows. Pre-Contemplation Pre-contemplation is the stage where the target population is not ready to take actions regarding their situation. Notably, most people at this stage assume that they are healthy and prefer not to concentrate on the future implications of their behaviors. Typically, most people who are ready to change their behaviors usually had already taken some actions regarding the same. Thus, they have already planned for what suits them the most as it pertains to their health.

That is, some had already enrolled in fitness programs, schedules consultations with health practitioners, chose to adhere to the recommended nutrition among other approaches. These are the people who are given the opportunity to guide others during the action-oriented phase. Action Action stage involves the target population modifying their lifestyles. Such behaviors can be maintained for a duration of as little as six months to as long as five years. Notably, after one year of continuous persistence, a significant parentage of people, begin engaging in their usual behaviors. Thus, the actions stage determines the success of the behavioral change program since it trains people to maintain the leaned behaviors. Failure of the stage means that the population may be vulnerable to relapse hence the failure of the whole project.

SECTION F: Implementation of the Proposed Solution Consent The potential subject of the intervention constitutes patient population suffering from mental-related conditions in Arizona State. Bi-weekly meetings will be conducted to alert the community about the potential benefits and implications of engaging and not engaging in the desired behaviors. The next one month will constitute the preparations stage. People’s readiness to act will be determined at this phase. The time will witness utilizing evaluation data to modify behavior and supporting individuals already pursuing desirable health activities to attract other parties who are yet to do so. The action stage will take roughly two months. The focus will be directed on every household at risk of suffering from obesity. The selected participants will be interviewed on a one-on-one basis.

In addition, questionnaires will be essential in collecting vital information. However, open-ended questions are preferred to close-ended questions since they allow participants to reflect on their behaviors and respond adequately. To evaluate the success of the program major variables will be measured. Impact evaluation functions to provide information about the implications of the intervention program. These may be positive or negative, direct or indirect, and intended or unintended outcomes. The approach is significant in establishing the causal attributions. Impact evaluation is ideal since it can be used to improve or reorganize the intervention including informing decisions of whether to discontinue, continue, or replicate the intervention (Billot et al. Furthermore, impact evaluation can be used in an ongoing intervention in EBP. A variety of approaches can be used to measure and evaluate the evidence.

Evidence from the project can be generated through similar health scores, monitoring recoveries, or comparing individuals’ outcomes (Billot et al. Outcome measures such as measuring changes in weight or blood pressure, improved perception of the condition, reduction in anxiety, and improved health provide reliable evidence. Calculating the project’s quality can be done by comparing the initial and current blood pressure for patients with heart conditions, establishing the intensity of physical exercise, or the rate breathing problems. Patient’s reported outcome measures constitute assessing the patients’ experience and perceptions towards their current health status. Identifying the population's significant concerns is critical in improving results which should be regularly evaluated and documented for future purposes. Even more, care feedback is vital in helping the patients track their health.

If possible, clinicians should be advised to provide feedback about what symptoms or warning signs that the patients should look for in the future. Equally, the population should be encouraged to schedule medical appointments on a regular basis as well as conduct self-evaluations to monitor their health (Billot et al. These strategies may have a significant impact on the outcome. Positive and Proactive Care: reducing the need for restrictive interventions. Accessed on 9/19/2018 from www. assets. publishing. service. assets. publishing. service. gov. uk/government/uploads/system/uploads/attachment_data/file/300293/JRA_DoH_Guidance_on_RP_web_accessible. A. , Gray, T. J. , & Gottlieb, T. Healthcare‐acquired infections: prevention strategies. , & Gilbert, G. E. Development and Psychometric Evaluation of the Simulation Culture Organizational Readiness Survey.