Correlation of sound and aggression: Does reducing sound levels decrease restraint and seclusion?

Purpose:
The purpose of this research is to collect data on sound levels to determine if more restraints/seclusions occur during times of transitions due to aggression brought on by higher volume of sound. The goal is to use intervention to decrease sound thereby, showing a decrease in restraint/seclusions.

Significance:
The RN role in the management of restraints/seclusions is an intricate part in patient care and assessment. Minimizing restraint/seclusion is of value to any psychiatric patient population. It is the nurse's role to have an understanding of potential antecedents in order to assist in de-escalation.

Strategy and Implementation:
Needs assessment concluded that about 50% of the restraints/seclusion occurred at four peak transition times. Feasibility assessment was completed to address any issues with time, availability of participants, cost, cooperation, equipment, experience, and ethical considerations. The independent variable is volume of sound. The dependent variable is aggressive behavior. The controlled variables are time, staffing, and location. Staff collected decibel sound level and restraint/seclusion data for the unit at the target transition times for a period of 6mths pre-intervention. Yacker trackers were placed in the 4 main rooms. Staff was educated on self-awareness and strategies to reduce sound during transitions. Some strategies included awareness of environment, such as, television turned off during patient hand off and strategic placement of staff during transitions. Signs were used as reminders. The same data as pre-intervention was collected post intervention for 6mths for comparison.

Evaluation:
Likert scale measured staff perception pre & post intervention & showed improvement of awareness of sound levels on the unit. Pearson's Correlation measured Pre & post data & showed significance for correlation between sound & aggression. Cronbach's Alpha was used to measure internal consistency.

Implications for Practice:
Increased level of sound on behavior has shown to lead to negative patient outcomes. Sound levels within psychiatric units should be maintained, especially during stressful times for patients. This can lead to improved patient care, increased employee satisfaction, & better patient outcomes.