Doctor of Nursing Practice (DNP) Projects

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Degree Program

Doctor of Nursing Practice

Degree Track

Psychiatric Mental Health Nurse Practitioner (PMHNP)

Year Degree Awarded


Month Degree Awarded



physical restraints, psychiatric nursing, restraint injury, quality of life, and verbal de-escalation


Dr. Karen Kalmakis PhD, MPH, FNP, FAANP

DNP Project Chair

Dr. Julia McDougal Ronconi, APRN DNP PMHNP-BC

DNP Project Outside Member Name

Sanh Angkhavong MSN, PMHNP, BC APRN


Purpose: Physical restraint, an intervention to manage psychiatric patients’ agitation, can potentially compromise patient medical and mental stability and can be avoided with verbal de-escalation. A lack of knowledge and confidence amongst nursing staff in the use of verbal de-escalation to minimize restraint use is a continuing problem. The purpose of this project is to improve nursing staff’s knowledge, attitudes, and confidence as it relates to verbal de-escalation techniques.

Methods: An educational intervention was offered for nursing staff of one psychiatric pediatric clinical setting and was implemented and evaluated using a pre and post-test design. Two questionnaires were given, to assess nursing staff’s knowledge and confidence, one month before and one month after the presentation. Four presentations were offered. Data was analyzed using descriptive statistics.

Results: Nursing staff’s confidence was noted to significantly improve when comparing the pre-intervention mean to the post-intervention mean. However, mixed results were noted on assessment of nursing staff’s knowledge of crisis management depending on which question was answered.

Conclusion: The educational intervention showed improvement in nursing staff’s confidence and knowledge on verbal de-escalation. Ideally this will result in decrease in physical restraint with further exploration.