Read by QxMD icon Read

seclusion restraints

A E Cullen, L Bowers, M Khondoker, S Pettit, E Achilla, L Koeser, L Moylan, J Baker, A Quirk, F Sethi, D Stewart, P McCrone, A D Tulloch
AIMS: Within acute psychiatric inpatient services, patients exhibiting severely disturbed behaviour can be transferred to a psychiatric intensive care unit (PICU) and/or secluded in order to manage the risks posed to the patient and others. However, whether specific patient groups are more likely to be subjected to these coercive measures is unclear. Using robust methodological and statistical techniques, we aimed to determine the demographic, clinical and behavioural predictors of both PICU and seclusion...
October 20, 2016: Epidemiology and Psychiatric Sciences
Morgan C Shields, Meredith B Rosenthal
OBJECTIVE: Little is known about the quality of inpatient psychiatric care. This study examined associations between performance on seven measures of inpatient psychiatric quality and hospital ownership. METHODS: The study design was a cross-sectional analysis of The Joint Commission's 2014 inpatient psychiatric hospital quality measures. The measures evaluate admission screening for violence risk, substance use, psychological trauma history, and patient strengths; use of seclusion and restraint; the practice of discharging patients on multiple antipsychotics; providing appropriate justification when patients are discharged on multiple antipsychotics; creation of continuing care plans; and transmission of care plans to the next level of care...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Joseph M Johnson, Chris Y Wu, Gerald Scott Winder, Michael I Casher, Vincent D Marshall, Jolene R Bostwick
Objective This study examines the association between cannabis use and the hospital course of patients admitted to the psychiatric inpatient unit with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder. Many confounding variables potentially contribute to the clinical presentation of hospitalized patients in the psychiatric unit. Illicit drug use, in particular, has been associated with acute agitation, and questions can be raised as to what lasting effects drug use prior to admission may have throughout a patient's hospital stay...
October 6, 2016: Journal of Dual Diagnosis
Sanaz Riahi, Ian C Dawe, Melanie I Stuckey, Philip E Klassen
Implementation of the Six Core Strategies to Reduce the Use of Seclusion and Restraint (Six Core Strategies) at a recovery-oriented, tertiary level mental health care facility and the resultant changes in mechanical restraint and seclusion incidents are described. Strategies included increased executive participation; enhanced staff knowledge, skills, and attitudes; development of restraint orders and decision support in the electronic medical record to enable informed debriefing and tracking of events; and implementation of initiatives to include service users and their families in the plan of care...
October 1, 2016: Journal of Psychosocial Nursing and Mental Health Services
Joshua C Felver, Richard Jones, Matthew A Killam, Christopher Kryger, Kristen Race, Laura Lee McIntyre
This research explored the effectiveness of a manualized contemplative intervention among children receiving intensive residential psychiatric care. Ten children with severe psychiatric disabilities received 12 sessions (30-45 min) of "Mindful Life: Schools" (MLS) over the course of a month. Facility-reported data on the use of physical intervention (i.e., seclusions and restraints) were analyzed. Acceptability questionnaires and broad-band behavioral questionnaire data were also collected from children and their primary clinicians...
October 1, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Vijay Danivas, Muffadal Bharmal, Paul Keenan, Steven Jones, Samuel Christaprasad Karat, Kumaran Kalyanaraman, Martin Prince, Caroline H D Fall, Murali Krishna
PURPOSE: Limited availability of specialist services places a considerable burden on caregivers of Persons with Dementia (PwD) in Low- and Middle-Income Countries (LMICs). There are limited qualitative data on coercive behavior towards PwD in an LMIC setting. AIM: The aim of this study was to find relevant themes of the lived experience of relatives as caregivers for PwD in view of their use of coercive measures in community setting in South India. METHOD: Primary caregivers (n = 13) of PwDs from the Mysore study of Natal effects on Ageing and Health (MYNAH) in South India were interviewed to explore the nature and impact of coercion towards community dwelling older adults with dementia...
September 29, 2016: Social Psychiatry and Psychiatric Epidemiology
Raj K Kalapatapu, Gordon M Giles
PURPOSE: The Relational Neurobehavioral Approach (RNA) is a set of non-aversive intervention methods to manage individuals with brain injury-related aggression. New data on interventions used in the RNA and on how the RNA interventions can be used with patients with acquired brain injury (ABI) who have differing levels of functional impairment are provided in this paper. METHOD: The study was conducted over a 6-week period in a secure 65-bed program for individuals with ABI that is housed in two units of a skilled nursing facility (SNF)...
September 16, 2016: Disability and Rehabilitation
Briana Marie Andrassy
PROBLEM: Restraints and/or seclusions (R/S) are events that have the potential to cause patient injury, staff injury, re-traumatization, and even death. There is a gap in available data regarding alternative strategies for reducing R/S. METHOD: A 140-bed children and adolescent residential treatment hospital implemented a "Feelings Thermometer Scale" on each unit. The "Feelings Thermometer" allowed the resident to point to a face on the scale to rate how they were feeling from "Cool" to "On Fire!" Once the resident identified with a feeling and rating, options were offered for alternative cool down locations corresponding to each level of escalation...
August 2016: Journal of Child and Adolescent Psychiatric Nursing
Joanne DeSanto Iennaco, Robin Whittemore, Jane Dixon
The aim of this study was to identify aggressive event incidence rates in the inpatient psychiatric setting, describe characteristics of events and differences based on aggression target and type (verbal vs. physical). A longitudinal study was carried out of aggressive events identified by workers in four inpatient psychiatric units using the Staff Observation of Aggression Scale-Revised (SOAS-R) over 6 weeks. A total of 113 aggressive events were recorded resulting in a rate of 13.27 events per bed per year...
August 25, 2016: Psychiatric Quarterly
S A Kinner, C Harvey, B Hamilton, L Brophy, C Roper, B McSherry, J T Young
AIMS: There are growing calls to reduce, and where possible eliminate, the use of seclusion and restraint in mental health settings, but the attitudes and beliefs of consumers, carers and mental health professionals towards these practices are not well understood. The aim of this study was to compare the attitudes of mental health service consumers, carers and mental health professionals towards seclusion and restraint in mental health settings. In particular, it aimed to explore beliefs regarding whether elimination of seclusion and restraint was desirable and possible...
August 12, 2016: Epidemiology and Psychiatric Sciences
Erich Flammer, Tilman Steinert
OBJECTIVE: In the German federal state of Baden-Wuerttemberg, involuntary medication of psychiatric inpatients was illegal during eight months from July 2012 until February 2013. The authors examined whether the number and duration of mechanical coercive measures (seclusion and restraint) and the number and severity of violent incidents changed in this period. METHODS: A cross-sectional analysis was conducted of admission-related routine data collected in seven psychiatric hospitals in three time periods (period 1, July 2011-February 2012; period 2, July 2012-February 2013; and period 3, July 2013-February 2014)...
August 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Corbin Bosse, Kandace Kelly
Electronic health record (EHR) usability concerns continue to reduce EHR effectiveness. LEAN methodology, which focuses on waste elimination, may provide an effective method to address efficiency related usability deficiencies. We aimed to improve the usability of an inpatient seclusion and restraint (SR) EHR module using LEAN methodology. A multidisciplinary team convened to evaluate and redesign clinical and technological SR workflows using LEAN techniques, including process mapping and time-series analyses...
2016: Studies in Health Technology and Informatics
V Mavandadi, P J Bieling, V Madsen
UNLABELLED: WHAT IS KNOWN ON THE SUBJECT?: Verbal de-escalation is an intervention aimed at calmly managing an agitated client to prevent violence. Effective de-escalation can help reduce the use of seclusion and restraint in psychiatric settings. Despite its importance in practice, there is little agreement on the necessary techniques of de-escalation and most of the research on the topic is based on expert opinion. To our knowledge, only one attempt at quantifying de-escalation skill has been pursued through the German-language De-Escalating Aggressive Behaviour Scale (DABS)...
August 2016: Journal of Psychiatric and Mental Health Nursing
Nakia M Hamlett, Erika R Carr, Marc Hillbrand
Positive behavior support (PBS) plans are increasingly used on inpatient units to assess and treat serious and dangerous behaviors displayed by patients with serious psychiatric impairment. A contemporary extension of traditional applied behavior analytic procedures, PBS plans integrate theories from several domains with perspectives on community psychology, positive psychology, and recovery-oriented care. Because there is little evidence to suggest that more invasive, punitive disciplinary strategies lead to long-term positive behavioral change (Parkes, 1996), PBS plans have emerged as an alternative to the use of seclusion and restraint or other forms of restrictive measures typically used on inpatient psychiatric units (Hammer et al...
May 2016: Psychological Services
Peter Lepping, Barkat Masood, Erich Flammer, Eric O Noorthoorn
BACKGROUND: Previous studies comparing restraint data from different countries had to rely on randomly published data and showed wide variance in the prevalence of restraint between countries. AIM: To systematically compare datasets from four similar European countries with regard to restraint prevalence. METHODS: We analysed whole country or area datasets on restraint from Wales, Ireland, Germany and the Netherlands systematically, thus excluding selection, patient and setting bias...
September 2016: Social Psychiatry and Psychiatric Epidemiology
Heikki Korkeila, Anna-Maija Koivisto, Eija Paavilainen, Jari Kylmä
The purpose of this study was to describe psychiatric nurses' emotional and ethical experiences regarding seclusion and restraint, and factors associated with these experiences. The data (n = 165) was collected in southern Finland, using the electronic version of the Seclusion and Restraint Experience Questionnaire (SREQ) and analyzed with statistical methods. We found that the experiences of control and duty were strongly emphasized in responses, especially among nurses with short work experience or temporary employment...
July 2016: Issues in Mental Health Nursing
Cath Roper, Bernadette McSherry, Lisa Brophy
The practices of seclusion and restraint may be used in a variety of health settings to control behaviour. Laws and policies that seek to regulate these practices define seclusion and restraint in various ways and there are gaps as to which practices are regulated and in what circumstances. This column provides an overview of consumer and carer perspectives as to what is meant by these practices.
December 2015: Journal of Law and Medicine
Lisa M Brophy, Catherine E Roper, Bridget E Hamilton, Juan José Tellez, Bernadette M McSherry
Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings.Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.Results All participants supported the reduction of the use of seclusion and restraint...
March 3, 2016: Australian Health Review: a Publication of the Australian Hospital Association
Astrid Furre, Leiv Sandvik, Svein Friis, Maria Knutzen, Ketil Hanssen-Bauer
The purpose of this study was to examine the type, reason, and duration of restraint episodes in acute adolescent psychiatric units. In a retrospective design we included data from paper-based protocols on all episodes of restraint and data from electronic patient records during 2008-2010 in all acute adolescent psychiatric in-patient units in Norway (N=16). The episodes of restraint included mechanical and pharmacological restraint, seclusion and physical holding that was not part of the implementation of forced feeding...
March 30, 2016: Psychiatry Research
Ellen W Blair, Stephen Woolley, Bonnie L Szarek, Theodore F Mucha, Olga Dutka, Harold I Schwartz, Jeff Wisniowski, John W Goethe
The authors describe a quality and safety initiative designed to decrease seclusion/restraint (S/R) and present the results of a pilot study that evaluated the effectiveness of this program. The study sample consisted of consecutive admissions to a 120-bed psychiatric service after the intervention was implemented (October 2010-September 2012, n = 8029). Analyses compared S/R incidence and duration in the study sample to baseline (consecutive admissions during the year prior to introduction of the intervention, October 2008-September 2009, n = 3884)...
February 20, 2016: Psychiatric Quarterly
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"