The increased number of incidents of aggression in the adult acute inpatient psychiatry unit of a facility in a large metropolitan area higher than the national average for comparable units and averaging about 48 incidents a month with about half resulting to injuries created an urgency to make a change in practice. A national push to use less restrictive interventions led to the proposal to the treatment team to explore the use of environmental centered care to reduce in incidents of aggression. Research shows that more than two-thirds of the patients committed as a danger to others are likely to engage in some type of violence 72 hours after admission. The current practice using restrictive interventions, such as restraint/seclusion and or medication had not been effective. The purpose of this scholarly project was to use a non-restrictive intervention called environmental-centered care (ECC) consisting of use of relaxation music, and light and noise reduction to reduce the incidents of aggression during peak incidents time, which is mostly during nursing shift change based on the institutions data.
