Clinical
Expertise
and Programs
Develop and lead the nation in
specialty nursing care models that
balance excellence, effectiveness and
efficiencies across systems
30
EXEMPLARY PROFESSIONAL PRACTICE
Time Out to Check In
Reducing Patient Hours in Restraints with Safety in Mind
Our Emergency Department at the Anschutz Campus offers
help to children and families in crisis—and with crisis comes
heightened emotions that can manifest as aggression and
unsafe behavior. It’s the job of our Emergency Department
and staff to de-escalate these situations and mitigate unsafe
behaviors. Sometimes, that involves restrictive techniques.
But restrictive de-escalation techniques pose multiple risks,
including psychological and physical trauma. And while they’re
sometimes necessary to keep the patient and other safe until
they can regain control, the Pediatric Mental Health Institute
launched a cross-departmental initiative in early 2018 to reduce
the number of patient hours in restraints while still maintaining
the safety of patients and staff.
With a target goal of decreasing restraint hours by 7.07 or fewer
hours per month, the Psych Emergency Department created
a restraint and seclusion taskforce. Working together, this
ad-hoc team created a process called “Time Out,” in which,
once a patient reaches 30 minutes in restraint or seclusion, the
psychiatrist, nurse and mental health counselor come together
to discuss and implement next steps to get the patient in a less
traumatic setting.
Since implementing this taskforce and the Time Out process,
the Emergency Department has decreased hours spent in
restraints by 33 percent, and the overall number of events
decreased from 117 in 2017 to 80 events in 2018. This year,
they’ve continued to make significant strides.
Clinical Expertie and Programs | 31