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Exploring the complexity of acute inpatient mental health nurses experience of chemical restraint interventions: Implications on policy, practice and education

Published:March 14, 2022DOI:https://doi.org/10.1016/j.apnu.2022.03.002

      Highlights

      • The reasearch question was: what are mental health nurses' experiences of using chemical restraint interventions in times of behavioural emergency on adult inpatient acute mental health units?
      • Three themes that emerged were: (1) working within constraints, (2) making medication choices, and (3) transitioning from novice to expert.
      • This exploratory research provides insights into the complex clinical and ethical decision-making involved in mental health nurses' use of chemical restraint interventions.
      • Findings can be used to develop standard policy, practice and education strategies that consider ways nurses make meaning of chemical restraint use.

      Abstract

      Chemical restraint research is growing with multiple healthcare disciplines increasing focused on understanding uses, harms of restraint and restraint reduction in inpatient mental health settings. Despite increased restraint research relatively little is known about nurses' experiences of administering chemical restraint. The research question guiding this study was: what are mental health nurses' experiences of using chemical restraint interventions in times of behavioural emergency on adult inpatient acute mental health units? The purpose of the research was to understand direct care nurses' first-hand experiences in use of chemical restraint interventions. Eight adult acute inpatient mental health nurses were interviewed using hermeneutic phenomenological method. The aim of this paper to discuss three themes that emerged in the research which clearly highlight the complex ethical issues and education needs of mental health nurses who use chemical restraint: working within constraints, making medication choices, and transitioning from novice to expert. Research findings indicated a need for further focus on medication best practice, policy development and nurse education. These exploratory research findings can be used to both inform and challenge dominant inpatient mental health practice to guide nurses, health care leaders, and policy makers by increasing understanding of the complex ethical decision-making required for use of chemical restraint interventions. Education strategies can be developed from the findings which highlight integral ways that nurses make meaning in their administering of chemical restraint, and their accompanied insights into the complex clinical and ethical decision-making aspects involved in nursing care.

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