Reducing the use of Restraints in a Child & Adolescent ward
Care Process & Redesign
National Healthcare Group Quality Improvement
National Healthcare Group
24 December 2025
To reduce the episodes of 4-5 point restraint (more than 120 minutes) in a Child and Adolescent Ward (W30A) by 50% within 6. Restraints, Child, Adolescent, Psychology, Cost Saving, Quality Improvement.
Year Submitted: 2025
Published Date: 24 December 2025
Tags: Care Process ＆ Redesign, Cost Saving, Quality Improvement, Productivity, Clinical Practice Improvement
About this Content
Aims
To reduce the episodes of 4-5 point restraint (more than 120 minutes) in a Child and Adolescent Ward (W30A) by 50% within 6 months.
Background
Ethical, moral, and legal considerations associated with use of restraints on youths. Physical and psychological impacts include laceration, bruises, nerve damage, pressure ulcers, infections, anger, fear, denial, humiliation, loss of dignity, trauma, confusion, depression, agitation, and regressive behaviours. Clinical guidelines state restraints for children and adolescents should not exceed 2 hours.
Methods
Consistent monitoring and regular PDSA cycles allowed for quick adaptations to challenges. Collaborative multidisciplinary effort was essential.
Results
Cost savings in reduction of 35 restraint episodes (from 47 episodes to 12 episodes) amounted to $22,120. Cost savings per annum: $265,440.
Conclusion
Restraints, Child, Adolescent, Psychology, Cost Saving, Quality Improvement
Lessons Learnt
Overall downward trend achieved through consistent monitoring. System changes require careful planning to minimize impact on restraint rates. Patient profiles influence restraint episodes. Quality improvement is an ongoing journey.
Keywords
Restraints, Child, Adolescent, Psychology, Cost Saving, Quality Improvement
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | National Healthcare Group Quality Improvement |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Psychology |
Project Lead(s) | Poh Zhi Qian Brian |
Project Member(s) | Tan David |
Connect with this contributor!
Group Quality - nhggroup.QRM@nhghealth.com.sg
Project Attachment
945_IMH_2025_QI_Award_Reducing_the_use_of_Restraints_in_a_Child_Adolescent_ward.pdf