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Task description:
Identify an area of specialisation in the health setting which interests
you. From your experiences in the degree so far or from an exploration
of the literature, identify a gap in education which has an impact on
nursing practice or consumer outcomes in this specialisation area. Write
a proposal for an education tool to help close this gap.
Identifies an area of specialty within the health setting
Related to criterion 1 150 words
6%
The preferred area of specialisation that has been chosen for addressing
this assignment is psychiatric nursing, caring for patients with
psychiatric disorders. Psychiatric disorders can be referred to as mental
health disorders that is characterised by depressed mood and loss of
interest in activities, mood swings, delusional thinking, altered thoughts
and perceptions (An et al. 2013). Patients with psychotic disorders often
become violent, which can become a reason of harm for the other
patients as well as the health care workers. For the sake of the safety of
the patient and the other patients in the ward, the health care
professionals and the nurses sometimes use mechanical or chemical
restraints to manage the patients. There had been cases, where
mechanical restraints had been used in patients without any reason and
just because of the fact that the patient has been diagnosed with
psychotic disorders.
Relevant research of a high level is used to identify and justify an
educational gap within this specialty area
Related to criterion 1 200-300
words15%
As strong educational gap is present among the psychiatric nurses as
well as the other health care workers regarding the use of restraints in
patients with psychotic disorders. As per the studies physical restraints
are physically harmful and is generally used if the alternate methods are
not adequate to protect them or other. It can be harmful depending
upon the severity of the restraints applied. Hence, nurses should be
knowledgeable about the possible complications behind the use of
restraints and should follow up the patients, who are under restraints. It
the nurses who are obligated to establish a safe and a therapeutic
environment for patients. It has been found that most of the nurses do
not have enough knowledge about the effect of restraints in psychotic
patients Eskandari et al. (2017). Lack of knowledge about the use of
physical restraints restricts them to establish a curative relationship
with the patients. In a study by Göktaş and Buldukoğlu (2018), it has
been found that although some of the nurses have knowledge physical
ill effects of knowledge, but most of them are not aware of the other
complications like the decrease in the self-esteem and loss of
reputation, which might affect the social life of the patient. In can be
seen that the nurses require appropriate training and teaching
regarding the ill effects of restraints and the various other alternative

options that can be chosen.
Analysis of impact of educational gap undertaken
Related to criterion 2 300-400
words25%
The educational gap among the nurses and the health care
professionals includes negative perception regarding the psychotic
patients, fear of getting hurt from the patients, lack of knowledge and
education about the harmful effects of putting restraints. Some of the
nurses also have the perception, that psychotic patient necessarily do
not
Feel the pain, due to their reduced pain sensitivity. Again, some of the
psychiatric nurses have also considered staff insufficiency to be one of
the main reason for restraint, especially when the patient is irritable or
aggressive. However, in a study studying about nurse’s perception, the
nurses have claimed that they explain the reason for the restraints to
the patient and to the families, but there are records where it has been
found that often no consent is being taken from the patient’s family or
the health care professionals do not carry out proper assessment of the
patients post restraint application (Moghadam, Khoshknab and
Pazargadi 2014). Because of this educational gap, the nursing health
professionals sometimes get beaten up.
It has been widely stated in the literatures that, complications like
restriction the blood circulation in the areas where restraints has been
applied, deterioration of skin integrity, respiratory problems, loss of self-
esteem, fear, anger and humiliation. Normally physical restraints are
used to reduce the risk of falling or harming himself or the other.
Various studies have claimed that both physical and chemical restraint
is only legitimate if the patient is benefitted directly from the
intervention or the benefit has been proven, scientifically (Chieze et al.
2019). Knowles, Hearne and Smith (2015) have stated that emotional
effect of being involved in practicing the restraint and the nurses taking
part in the restraint application can greatly affect patient and nurse
alliance (Knowles, Hearn and Smith 2015). There is a lack of study
proving any effectiveness of restraints on psychiatric patients. Treating
of mental health patients should always be patient-specific. A patient
centred care is built upon trust and therapeutic relationship with the
patient. Lack of trust among the patient and the nurse can lead to
deteriorated care like non-adherence to treatment regimen, or
developing delusional thoughts against the health care professional. For
example, a psychotic patients who had been put under restraint might
develop a fear of getting killed by doctors and the nurses. This can
aggravate the situation further and can increase the level of aggression
in patient. Application of restraints not only strain the patient-therapist
relationship but also affects the type of care provided (Hammervold et
al. 2019). It also compromises the reputation of the health care
organisation.
Target audience for education tool is clearly identified
Related to criterion 3 150 words