Discussion
Four unit RNs were queried about possible reasons they thought clients did not use the comfort rooms (sidebar). How many times clients refused to use the comfort room when it was offered was not document or considered as part of this project.
Changes in the rates of each event cannot be fully attributed to the comfort room, as numerous variables are involved, including different clients throughout this period, the fact that one client's actions could significantly alter the outcome, and that other alternatives may also have been used that were not documented. The data collection period was limited to 4 months of data prior to and after inception of the comfort room. future studies are needed to evaluate other variables the might indicate success with the comfort rooms, including analyzing clients' underlying mental health disorders, gender, age, or change in number of extra medications used.
Although not all goals were met, positive outcomes were noted with decreased rates of CTCA and CTSA, as well as zero use of seclusion and mechanical restraints. In addition, no one used additional antianxiety or antipsychotic medications within 30 minutes before or after using the room, which could indicate that the participants used the comfort room as an alternative to asking for extra medication. Although the cost of supplies for these two rooms was close to $11,500, there are no rules about how little to spend in the development of these rooms. The cost savings in staff time and staff and client injuries, as well as the negative emotional effect on both parties involved, was not measured, although measuring these outcomes could be warranted for future studies. The hospital’s leadership believed the comfort rooms proved to be a viable intervention that allowed clients to practice self-management techniques in coping with their anxiety or anger in an acceptable manner, as well as a preventive tool to the use of seclusion or restraint. The comfort room committee continues to meet quarterly to review feedback forms, to identify areas needing improvement, and to assess the outcomes data.
Due to the success of this pilot project in markedly decreasing restraint, plans are underway to create comfort rooms on the remaining units. Although adoption of this approach was not discussed at a statewide level, if this facility could save approximately $1,500 in a 13 month time frame-and the other five facilities within the state followed suit there could be a statewide cost savings of $9,000.