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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
#1
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
#2
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
#3
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...
November 16, 2016: 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
#4
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
#5
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
#6
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
#7
Sophie A Pettit, Len Bowers, Alex Tulloch, Alexis E Cullen, Lois Biggin Moylan, Faisil Sethi, Paul Mccrone, John Baker, Alan Quirk, Duncan Stewart
AIMS: 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 of 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 of these two containment methods in some hospitals may trigger compensatory increases in other forms of containment which have potential risks...
November 3, 2016: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/27763251/factors-associated-with-use-of-psychiatric-intensive-care-and-seclusion-in-adult-inpatient-mental-health-services
#8
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
https://www.readbyqxmd.com/read/27745537/quality-of-inpatient-psychiatric-care-at-va-other-government-nonprofit-and-for-profit-hospitals-a-comparison
#9
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
https://www.readbyqxmd.com/read/27710762/the-effects-of-cannabis-on-inpatient-agitation-aggression-and-length-of-stay
#10
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...
July 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27699424/implementation-of-the-six-core-strategies-for-restraint-minimization-in-a-specialized-mental-health-organization
#11
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
https://www.readbyqxmd.com/read/27696136/contemplative-intervention-reduces-physical-interventions-for-children-in-residential-psychiatric-treatment
#12
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
https://www.readbyqxmd.com/read/27689233/an-interpretative-phenomenological-analysis-ipa-of-coercion-towards-community-dwelling-older-adults-with-dementia-findings-from-mysore-studies-of-natal-effects-on-ageing-and-health-mynah
#13
Vijay Danivas, Mufaddal 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...
December 2016: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/27636708/the-relational-neurobehavioral-approach-can-a-non-aversive-program-manage-adults-with-brain-injury-related-aggression-without-seclusion-restraint
#14
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
https://www.readbyqxmd.com/read/27633435/feelings-thermometer-an-early-intervention-scale-for-seclusion-restraint-reduction-among-children-and-adolescents-in-residential-psychiatric-care
#15
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
https://www.readbyqxmd.com/read/27562175/aggressive-event-incidence-using-the-staff-observation-of-aggression-scale-revised-soas-r-a-longitudinal-study
#16
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
https://www.readbyqxmd.com/read/27515597/attitudes-towards-seclusion-and-restraint-in-mental-health-settings-findings-from-a-large-community-based-survey-of-consumers-carers-and-mental-health-professionals
#17
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
https://www.readbyqxmd.com/read/27476807/association-between-restriction-of-involuntary-medication-and-frequency-of-coercive-measures-and-violent-incidents
#18
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)...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27332384/improving-ehr-usability-using-lean-methodology
#19
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
https://www.readbyqxmd.com/read/27271938/effective-ingredients-of-verbal-de-escalation-validating-an-english-modified-version-of-the-de-escalating-aggressive-behaviour-scale
#20
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
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