Implementation of soothing rooms for adults and adolescents in an acute mental health unit in a Midwestern regional hospital resulted in a 35% reduction in the use of restraints among the adult patients, demonstrating a benefit to both patients and mental health nurses by reducing restraint usage and suggesting a new standard of care.

The effectiveness of soothing rooms was evaluated in an acute 32-bed mental health care unit at the SwedishAmerican Center for Mental Health, Rockford, Illinois, USA. Representatives from leadership and unit staff presented the results of implementing this new standard of care that the Center for Mental Health provided for nurses.

Defined as a safe and calming environment with sensory objects where escalating patients may self-soothe, soothing rooms incorporate a holistic approach based on a caring attitude, a caring environment, and the development of a trusting nurse-patient relationship.

Patients admitted to mental health facilities should be introduced to a soothing room, and the rooms should be further used during routine patient interactions, during psychological educational groups, at the first sign of patient escalation, and at all other appropriate opportunities.

In the planning stages of these rooms, representatives of all disciplines—including clinical nurses, recreational therapists, behavioral therapists, and the leadership—designed 2 soothing rooms partially based on ideas from a 2009 guide published by the New York State Office of Mental Health [MacDaniel M. NYSOMH. 2009]. The rooms were painted in neutral and peaceful color schemes with minimal décor and lighted blue-sky ceiling tiles. Positive wall messages, recliner chairs, and a private bathroom with a nature-scene door added to the soothing aesthetic environment.

To further help patients self-soothe, the rooms included sensory objects, such as art therapy tools, DVDs with nature scenes, games and puzzles, music, raised sandboxes for the adult room, weighted blankets, and stress balls.

The soothing rooms were used on a voluntary basis only, and nurses offered them to patients at the first sign of patient distress. When a patient was in the room, he or she was monitored every 15 minutes and allowed to stay in the room for a maximum of 30 minutes. The soothing rooms were not used as a reward or punishment, nor for patients who were unable to use the room safely. The study showed a 35% reduction in the use of restraints (Figure 1).

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Figure 1.

Results of the Use of Soothing Rooms on Restraint Usage

Results of the SwedishAmerican Center for Mental Health soothing rooms' impact on restraints/seclusion episodes. Analysis indicated that incidences of restraints and seclusion decreased after soothing rooms opened.Reproduced with permission from A Kirsch, MSN, RN.

According to presenters, prior to the implementation of the soothing rooms, there had been limited alternatives to restraints. After implementation of the soothing rooms, presenters said, restraints are no longer the norm and are only used in crises situations. Presenters emphasized that the 35% reduction in the use of restraints has also reduced the degree of trauma for patients as well as staff.

To validate the evidence, the clinical nurses gathered subjective data from the adults and adolescents through written evaluation that rated their stress levels before and after use of the soothing rooms. The presenters said that this feedback validated the results of the study and overall validates implementation of soothing rooms as the new standard of inpatient care.