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https://www.readbyqxmd.com/read/28506820/seasonal-variation-of-hospital-violence-seclusion-and-restraint-in-a-forensic-psychiatric-hospital
#1
Satu Kuivalainen, Katri Vehviläinen-Julkunen, Olavi Louheranta, Anu Putkonen, Eila Repo-Tiihonen, Jari Tiihonen
Several epidemiological studies have reported seasonal patterns in both violent and self-destructive behaviour. However, a few studies on hospital violence have found contradictory results. The aim of this study was to investigate whether there was any seasonal variation of violence in a forensic psychiatric hospital providing care for persons suffering from psychotic disorders and violent or self-destructive behaviour. Seasonal variation of the prevalence of seclusion and restraint was also investigated. Reports of violent incidents and seclusion and restraint statistics from between 2007 and 2012 were examined with Poisson regression analysis...
May 12, 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/28503194/what-are-effective-strategies-for-implementing-trauma-informed-care-in-youth-inpatient-psychiatric-and-residential-treatment-settings-a-realist-systematic-review
#2
REVIEW
Stephanie A Bryson, Emma Gauvin, Ally Jamieson, Melanie Rathgeber, Lorelei Faulkner-Gibson, Sarah Bell, Jana Davidson, Jennifer Russel, Sharlynne Burke
BACKGROUND: Many young people who receive psychiatric care in inpatient or residential settings in North America have experienced various forms of emotional trauma. Moreover, these settings can exacerbate trauma sequelae. Common practices, such as seclusion and restraint, put young people at risk of retraumatization, development of comorbid psychopathology, injury, and even death. In response, psychiatric and residential facilities have embraced trauma-informed care (TIC), an organizational change strategy which aligns service delivery with treatment principles and discrete interventions designed to reduce rates of retraumatization through responsive and non-coercive staff-client interactions...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28500477/impact-of-a-program-for-the-management-of-aggressive-behaviors-on-seclusion-and-restraint-use-in-two-high-risk-units-of-a-mental-health-institute
#3
Steve Geoffrion, Jane Goncalves, Charles-Édouard Giguère, Stéphane Guay
The Omega Program for the Management of Aggressive Behaviors aims to reduce patients' dangerous behaviors, towards themselves or others, and to reduce the use of seclusion and restraint (S/R). A previous study in a Mental Health Institute (Montreal, Canada) showed that implementing this program allowed employees of the intensive care and emergency units to gain confidence in coping with patients' aggressions and to reduce their psychological distress. The present study, conducted in the same high-risk units, assesses the effect of the program on S/R use...
May 13, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28484822/-dgppn-recommendations-on-quality-indicators-for-schizophrenia
#4
I Großimlinghaus, I Hauth, P Falkai, B Janssen, A Deister, A Meyer-Lindenberg, C Roth-Sackenheim, F Schneider, T Wobrock, R Zeidler, W Gaebel
BACKGROUND: In Germany, several quality indicators have been proposed for the measurement of quality of mental healthcare. Some of these quality indicators have been tested in feasibility studies. The German Association for Psychiatry and Psychotherapy (DGPPN) established the "Task Force Quality Indicators (QI)" that, based on previous experience in the development and pilot testing of indicators, considered the further development and practical realization of QI for schizophrenia. AIM: The aim was to select a set of QI for schizophrenia that can also be applied to other diagnoses or used in generic measurements...
May 8, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28412887/preventing-and-de-escalating-aggressive-behavior-among-adult-psychiatric-patients-a-systematic-review-of-the-evidence
#5
Bradley N Gaynes, Carrie L Brown, Linda J Lux, Kimberly A Brownley, Richard A Van Dorn, Mark J Edlund, Emmanuel Coker-Schwimmer, Rachel Palmieri Weber, Brian Sheitman, Theodore Zarzar, Meera Viswanathan, Kathleen N Lohr
OBJECTIVE: The project goal was to compare the effectiveness of strategies to prevent and de-escalate aggressive behaviors among psychiatric patients in acute care settings, including interventions for reducing use of seclusion and restraint. METHODS: Relevant databases were systematically reviewed for comparative studies of violence prevention and de-escalation strategies involving adult psychiatric patients in acute care settings. Studies (trials and cohort studies) were required to report on aggression or seclusion or restraint outcomes...
April 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28372555/study-protocol-for-a-cluster-randomised-controlled-trial-to-assess-the-effectiveness-of-user-driven-intervention-to-prevent-aggressive-events-in-psychiatric-services
#6
Maritta Välimäki, Min Yang, Sharon-Lise Normand, Kate R Lorig, Minna Anttila, Tella Lantta, Virve Pekurinen, Clive E Adams
BACKGROUND: People admitted to psychiatric hospitals with a diagnosis of schizophrenia may display behavioural problems. These may require management approaches such as use of coercive practices, which impact the well-being of staff members, visiting families and friends, peers, as well as patients themselves. Studies have proposed that not only patients' conditions, but also treatment environment and ward culture may affect patients' behaviour. Seclusion and restraint could possibly be prevented with staff education about user-centred, more humane approaches...
April 4, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28337845/nurses-attitudes-towards-the-use-of-prn-psychotropic-medications-in-acute-and-forensic-mental-health-settings
#7
Lesley Barr, Dianne Wynaden, Karen Heslop
Many countries now have national mental health policies and guidelines to decrease or eliminate the use of seclusion and restraint yet the use of Pro Re Nata (PRN) medications has received less practice evaluation. This research aimed to identify mental health nurses' attitudes towards the use of PRN medications with mental health consumers. Participants were working in forensic mental health and non-forensic acute mental health settings. The "Attitudes towards PRN medication use survey" was used and data were collected online...
March 24, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28287863/music-therapy-as-a-nonpharmacological-intervention-for-anxiety-in-patients-with-a-thought-disorder
#8
Allison Pavlov, Kirstyn Kameg, Tom W Cline, Laurel Chiapetta, Stacy Stark, Ann M Mitchell
Music therapy has been identified as a non-pharmacological adjunct therapy to treat anxiety. This QI project aimed to assess the effects of music therapy on anxiety in a sample of patients hospitalized with a thought disorder. Participants were assessed pre- and post-group using a visual analog scale for anxiety. The intervention significantly reduced VAS scores from 3.1 pre-intervention to .897 immediately post-intervention (p = 0.008). This data suggests that music therapy may be beneficial in the short term for this population and is a low risk intervention that provides positive outcomes without the risks associated with medications, seclusion, and restraint...
March 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28270460/a-positive-behavioral-approach-for-aggression-in-forensic-psychiatric-settings
#9
Peter Tolisano, Tracey M Sondik, Charles C Dike
Aggression toward self and others by complex patients admitted to forensic psychiatric settings is a relatively common yet extremely difficult behavior to treat. Traditional interventions in forensic inpatient settings have historically emphasized control and management over treatment. Research over the past several years has demonstrated the value of behavioral and psychosocial treatment interventions to reduce aggression and to increase prosocial skill development in inpatient forensic population. Positive behavioral support (PBS) offers a comprehensive approach that incorporates the science of applied behavioral analysis (ABA) in support of patients with challenging behaviors, including aggression and violence...
March 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/28103871/a-descriptive-survey-study-of-violence-management-and-priorities-among-psychiatric-staff-in-mental-health-services-across-seventeen-european-countries
#10
Seamus Cowman, Anna Björkdahl, Eric Clarke, Georgina Gethin, Jim Maguire
BACKGROUND: In mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach. METHODS: The project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG)...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28098921/-does-less-seclusion-create-a-safer-environment-an-attempt-to-map-the-concept-of-feeling-safe
#11
C J Severs, A J K Hondius, A H Schene
The degree of restraint imposed by a psychiatrist seems to be influenced by the safety of the team. So far, there have been few attempts to map the concept of 'feeling safe'.<br/> AIM: To analyse, define and quantify the concept of 'feeling safe'.<br/> METHOD: Concept mapping involves combining, in a structured way, qualitative (item collection) and quantitative methods (multi-dimensional scaling and hierarchical clusteranalysis) with the knowledge of professionals from psychiatric practice (N=24), first on an individual basis and then as a group (N=8)...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/27992811/seclusion-and-enforced-medication-in-dealing-with-aggression-a-prospective-dynamic-cohort-study
#12
A A Verlinde, E O Noorthoorn, W Snelleman, H van den Berg, M Snelleman-van der Plas, P Lepping
BACKGROUND: In the Netherlands, seclusion is historically the measure of first choice in dealing with aggressive incidents. In 2010, the Mediant Mental Health Trust in Eastern Netherlands introduced a policy prioritising the use of enforced medication to manage aggressive incidents over seclusion. The main goal of the study was to investigate whether prioritising enforced medication over seclusion leads to a change of aggressive incidents and coercive measures. METHODS: The study was carried out with data from 2764 patients admitted between 2007 and 2013 to the hospital locations of the Mediant Mental Health Trust in Eastern Netherlands, with a catchment area of 500,000 inhabitants...
December 16, 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/27984264/reducing-restraint-with-clozapine-in-involuntarily-admitted-patients-with-schizophrenia
#13
Petru Ifteni, Andreea S Szalontay, Andreea Teodorescu
BACKGROUND: In the entire world, restraint and seclusion are common interventions in psychiatric inpatient settings because of aggressive behavior. STUDY QUESTION: Our objective was to test for the immediate antiaggressive property of clozapine compared with other antipsychotic treatments in an enriched cohort with high rates of restraint during early hospitalization. METHODS: We present a retrospective chart review in all involuntary admissions with schizophrenia during 2011-2014 in Psychiatry and Neurology Hospital, Brasov, Romania...
March 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27910254/identification-and-analysis-of-factors-contributing-to-the-reduction-in-seclusion-and-restraint-for-a-population-with-intellectual-disability
#14
Caroline Larue, Marie-Hélène Goulet, Marie-Josée Prevost, Alexandre Dumais, Jacques Bellavance
BACKGROUND: A cohort of 11 patients with an intellectual disability and a psychiatric diagnosis present severe behavioural disorders in psychiatric hospital of Quebec in 2009. Control-measure use for this clientele has now been reduced. How do management personnel, families and care teams explain the changes? What clinical interventions did management and care providers implement that contributed to the reduction? METHOD: A retrospective case study was conducted...
December 2, 2016: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/27885664/haloperidol-plus-promethazine-for-psychosis-induced-aggression
#15
REVIEW
Gisele Huf, Jacob Alexander, Pinky Gandhi, Michael H Allen
BACKGROUND: Health services often manage agitated or violent people, and such behaviour is particularly prevalent in emergency psychiatric services (10%). The drugs used in such situations should ensure that the person becomes calm swiftly and safely. OBJECTIVES: To examine whether haloperidol plus promethazine is an effective treatment for psychosis-induced aggression. SEARCH METHODS: On 6 May 2015 we searched the Cochrane Schizophrenia Group's Register of Trials, which is compiled by systematic searches of major resources (including MEDLINE, EMBASE, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27864953/deaths-in-unlicensed-alcohol-rehabilitation-facilities-sup
#16
Keng-Chih Su, Lawrence Nguyen, Christopher Rogers
Non-English-speaking people do not always seek medical care through established institutions. This paper reports a series of deaths in unlicensed alcohol rehabilitation facilities serving Spanish-speaking men. These facilities are informal groups of alcohol abusing men who live together. New members receive various treatments, including administration of ethanol or isopropanol, restraint, and seclusion. We reviewed 42 deaths in unlicensed alcohol rehabilitation facilities in Los Angeles County during the years 2003-2014...
January 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27860236/association-of-methamphetamine-use-and-restrictive-interventions-in-an-acute-adult-inpatient-mental-health-unit-a-retrospective-cohort-study
#17
Brian McKenna, Samantha McEvedy, Kathleen Kelly, Bec Long, Jess Anderson, Elaine Dalzell, Tessa Maguire, Mark Tacey, Trentham Furness
The aim of the present study was to describe incidences of restrictive interventions and the association of methamphetamine use at an acute adult inpatient mental health unit in metropolitan Melbourne, Victoria, Australia. A total of 232 consecutive consumer admissions to the inpatient unit across a 3-month period were described for illicit substance use and the use of restrictive interventions (seclusion, mechanical restraint, and physical restraint) prior to and during admission. Of all admissions, 25 (10...
November 16, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27857778/state-of-acute-agitation-at-psychiatric-emergencies-in-europe-the-stage-study
#18
Luis San, Josef Marksteiner, Peter Zwanzger, María Aragüés Figuero, Francisco Toledo Romero, Grigorios Kyropoulos, Alberto Bessa Peixoto, Roxana Chirita, Anca Boldeanu
BACKGROUND: Agitation is an array of syndromes and types of behaviors that are common in patients with psychiatric disorders. In Europe, the estimation of prevalence of agitation has been difficult due to the lack of standard studies or systematic data collection done on this syndrome. OBJECTIVE: An observational, cross-sectional, multicenter study aimed to assess the prevalence of agitation episodes in psychiatric emergencies in different European countries. METHOD: For 1 week, all episodes of acute agitation that were attended to at the psychiatric emergency room (ER) or Acute Inpatient Unit (AIU) in the 27 participating centers were registered...
2016: Clinical Practice and Epidemiology in Mental Health: CP & EMH
https://www.readbyqxmd.com/read/27845534/transformation-to-a-recovery-oriented-model-of-care-on-a-veterans-administration-inpatient-unit
#19
Jessica B Zuehlke, Robert M Kotecki, Shira Kern, Gretchen Sholty, Peter Hauser
OBJECTIVES: Recovery-oriented care is among the highest treatment priorities for the Veteran Health Administration, which has endorsed organizational change of mental health care to reflect recovery values. The purpose of this quality improvement project was to determine whether recovery interventions would yield positive outcomes when delivered on in inpatient psychiatry. METHOD: Recovery interventions on the unit included recovery-focused interdisciplinary team meetings, opportunities for stakeholder feedback, recovery staff education, increased group programming, peer support, and changes to treatment planning to include increased Veteran engagement and responsibility...
December 2016: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/27809370/acceptability-and-use-of-coercive-methods-across-differing-service-configurations-with-and-without-seclusion-and-or-psychiatric-intensive-care-units
#20
Sophie A Pettit, Len Bowers, Alex Tulloch, Alexis E Cullen, Lois Biggin Moylan, Faisil Sethi, Paul McCrone, John Baker, Alan Quirk, Duncan Stewart
AIMS: The aim of this study was to compare across different service configurations the acceptability of containment methods to acute ward staff and the speed of initiation of manual restraint. BACKGROUND: One of the primary remits of acute inpatient psychiatric care is the reduction in risks. Where risks are higher than normal, patients can be transferred to a psychiatric intensive care unit or placed in seclusion. The abolition or reduction in these two containment methods in some hospitals may trigger compensatory increases in other forms of containment which have potential risks...
April 2017: Journal of Advanced Nursing
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