Page 11 - UHN Centre for Mental Health Impact Report 2023

ACUTE CARE & GENERAL PSYCHIATRY

Protecting Patients and Staff Alternatives to Restraints

Creating a Safer Healthcare Enviornment at UHN. Staff Nurses Emphasize Trauma-Informed Approaches.

In a recent quality improvement project, two nurses — Megan
Smith and Rachel Yang —highlight the range of options available
instead of depending on physical restraints in mental health care.

“We wanted to promote alternative approaches that are the least
traumatizing,” says Rachel. “Trauma-informed care is the most
important aspect of mental health nursing.”

The resource created — “Enhancing the Use of Alternative “To witness the
Approaches to Physical Restraints” — covers a range of prevention outstanding work
strategies: from ways to build rapport with patients and enhance Rachel and
assessment skills, to grounding techniques and the benefits of
daily behavioural activation therapy. Megan did on this
project makes
Megan and Rachel drew on their nursing experience and me so proud to
education and also brought in evidence-based components via be a nurse at
research. Their resource was shared with Centre for Mental UHN.”
Dr. Christian Schulz-Quach and Ms. Charlene Reynolds
Health colleagues and posted on the unit department site. – Ms. Aideen Carroll,
When a UHN patient poses a danger to buttons, as well as increased security and Advance Practice
themselves or others and the situation psychiatry expertise. “We thought creating this educational resource would be a great Nurse Educator
could escalate beyond the abilities of opportunity to support and empower our new nurses and let
present staff to manage, a Code White To ensure timely interventions and estab- them know that there are other options,” says Megan.
is initiated — a coordinated emergency lish clear roles and responsibilities, the
response to safeguard individuals from committee participated in a large scale Ms. Megan Smith and Ms. Rachel Yang
violence at the point of care. quality improvement project, which
included conducting a needs assessment
UHN recently formed an organization- with 250+ members of Team UHN and
wide committee, co-led by the Centre identifying three priorities:
for Mental Health’s Dr. Christian Schulz-
Quach, staff psychiatrist, and Charlene • Implementing a comprehensive
Reynolds, Clinical Director, to review training program tailored to sites
incidences and improve Code White and program.
responses, management and training. • Standardize Code White protocols
into a 16-step process.
Code White’s have an immense emotion- • Explore establishing dedicated Code
al and psychological impact on patients White teams at each site.
and staff. While these complex situations
occur throughout UHN, needs vary across Implementing these priorities will
sites and programs. High-incidence areas enhance prevention, de-escalation and
require enhanced support, such as panic safety for both UHN patients and staff.
10 11