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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/28457209/patients-experiences-of-restrictive-interventions-in-australia-findings-from-the-2010-australian-survey-of-psychosis
#5
Nicole S Brady, Matthew J Spittal, Lisa Mary Brophy, Carol Ann Harvey
OBJECTIVE: The authors used survey data to investigate patients' experiences of restrictive interventions in inpatient settings. METHODS: The 2010 Australian Survey of High Impact Psychosis (N=1,825) asked about restrictive interventions experienced during a mental health admission in the previous year (N=428), ranging from restrictions on leaving a ward to seclusion. The authors explored the relationship between perceived benefit (good or limited versus no benefit) and the number of different types of restrictive interventions experienced...
May 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28456471/-i-can-t-go-out-mobility-obstacles-to-women-s-access-to-hiv-treatment-in-kpk-pakistan
#6
Abubakr Saeed, Shaista Farooq
We examined the role of outside mobility constraints as barriers to HIV treatment for Pakistani women living with HIV (WLWH) whose husbands were permanently living in other cities. We focused on Khyber Pakhtunkhwa (KPK), which adheres to conservative social and cultural values for female mobility. Open-ended interviews were conducted with 21 WLWH. We found that women's mobility outside the home was shaped by the system of parda (seclusion) and that a husband's lack of support by not being present for clinical appointments, distance to the HIV clinic, and ages of children emerged as crucial contributors to women's outside mobility and their subsequent abilities to access HIV care...
April 5, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28449014/ethnic-disparities-in-the-use-of-seclusion-for-adult-psychiatric-inpatients-in-new-zealand
#7
COMPARATIVE STUDY
Melissa McLeod, Paula King, James Stanley, Cameron Lacey, Ruth Cunningham
AIM: This study aims to investigate disparities in seclusion between Māori and non-Māori non-Pacific (nMnP) adults in mental health inpatient units in New Zealand. METHOD: This study uses data on 7,239 inpatient psychiatric admissions and 782 seclusion events for nine district health boards (servicing 39% of the New Zealand population) for the period 1 July 2008 to 30 June 2010, from a New Zealand Ministry of Health dataset (PRIMHD). We calculate the age-standardised rates of seclusion per monthly inpatient admissions...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28421661/safety-in-psychiatric-inpatient-care-the-impact-of-risk-management-culture-on-mental-health-nursing-practice
#8
Allie Slemon, Emily Jenkins, Vicky Bungay
The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm...
April 18, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28412887/preventing-and-de-escalating-aggressive-behavior-among-adult-psychiatric-patients-a-systematic-review-of-the-evidence
#9
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/28400967/unlocking-an-acute-psychiatric-ward-the-impact-on-unauthorised-absences-assaults-and-seclusions
#10
Ben Beaglehole, John Beveridge, Warren Campbell-Trotter, Chris Frampton
Aims and method The acute psychiatric in-patient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse event data before and after ward configuration change. Results Rates of unauthorised absences increased by 58% after the change in ward configuration (P = 0...
April 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28388296/nursing-staff-factors-contributing-to-seclusion-in-acute-mental-health-care-an-explorative-cohort-study
#11
Paul Doedens, Jolanda M Maaskant, Corine H M Latour, Berno K G van Meijel, Maarten W J Koeter, Jitschak G Storosum, Emile Barkhof, Lieuwe de Haan
BACKGROUND: Seclusion is a controversial intervention. Efficacy with regard to aggressive behaviour has not been demonstrated, and seclusion is only justified for preventing safety hazards. Previous studies indicate that nursing staff factors may be predictors for seclusion, although methodological issues may have led to equivocal results. OBJECTIVE: To perform a prospective cohort study to determine whether nursing staff characteristics are associated with seclusion of adult inpatients admitted to a closed psychiatric ward...
April 7, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28375028/six-years-of-national-mental-health-seclusion-data-the-australian-experience
#12
John A Allan, Gary D Hanson, Nicole L Schroder, Anna J O'Mahony, Roxanne M P Foster, Grant E Sara
OBJECTIVES: Reducing or eliminating seclusion from mental health care settings has been a national priority for Australia since 2005. This paper describes Australia's national seclusion data collection, and summarises changes in seclusion rates in Australian public mental health services. METHODS: Seclusion events per 1000 patient days were calculated from 2009-2010 to 2014-2015 utilising state and territory administrative data sources. Combined national data were used to calculate results for a number of service characteristics, such as target population and location of the service...
April 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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
#13
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/28368091/de-escalation-techniques-for-psychosis-induced-aggression-or-agitation
#14
REVIEW
Maolin Du, Xuemei Wang, Shaohua Yin, Wei Shu, Ruiqi Hao, Sai Zhao, Harish Rao, Wan-Ley Yeung, Mahesh B Jayaram, Jun Xia
BACKGROUND: Aggression is a disposition, a willingness to inflict harm, regardless of whether this is behaviourally or verbally expressed and regardless of whether physical harm is sustained.De-escalation is a psychosocial intervention for managing people with disturbed or aggressive behaviour. Secondary management strategies such as rapid tranquillisation, physical intervention and seclusion should only be considered once de-escalation and other strategies have failed to calm the service user...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28351023/effect-of-door-locking-policy-on-inpatient-treatment-of-substance-use-and-dual-disorders
#15
Regine Steinauer, Christian G Huber, Sylvie Petitjean, Gerhard A Wiesbeck, Kenneth M Dürsteler, Undine E Lang, Christian Seifert, Katja Andreeff, Michael Krausz, Marc Walter, Marc Vogel
OBJECTIVE: Substance use treatment is often performed inside locked wards. We investigate the effects of adopting a policy of open-door treatment for a substance use treatment and dual diagnosis ward. METHODS: This is a prospective open-label study investigating 3-month study periods before opening (P1), immediately after (P2), and 1 year after the first period (P3). Data on committed patients, coercion (seclusion, forced medication, absconding events with subsequent police search), violence, and substance use was collected daily...
2017: European Addiction Research
https://www.readbyqxmd.com/read/28337845/nurses-attitudes-towards-the-use-of-prn-psychotropic-medications-in-acute-and-forensic-mental-health-settings
#16
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/28323579/who-experiences-seclusion-an-examination-of-demographics-and-duration-in-a-public-acute-inpatient-mental-health-service
#17
Jacinta Chavulak, Melissa Petrakis
Restrictive interventions such as seclusion may occur during an acute mental health crisis. Such interventions are experienced by people as traumatic and counter to recovery. The current study aimed to investigate the use of seclusion and who was secluded amongst patients presenting with psychotic symptomology. All acute inpatient admissions were examined across a 12-month period January-December 2013. Electronic and paper records were accessed and audited for all 655 admissions. There were 91 admissions that included a seclusion and 200 seclusion events...
March 21, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28287863/music-therapy-as-a-nonpharmacological-intervention-for-anxiety-in-patients-with-a-thought-disorder
#18
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
#19
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/28225198/adjunctive-steroid-therapy-versus-antibiotics-alone-for-acute-endophthalmitis-after-intraocular-procedure
#20
REVIEW
Carole H Kim, Monica F Chen, Anne L Coleman
BACKGROUND: Endophthalmitis refers to severe infection within the eye that involves the aqueous humor or vitreous humor, or both, and threatens vision. Most cases of endophthalmitis are exogenous (i.e. due to inoculation of organisms from an outside source), and most exogenous endophthalmitis is acute and occurs after an intraocular procedure. The mainstay of treatment is emergent administration of broad-spectrum intravitreous antibiotics. Due to their anti-inflammatory effects, steroids in conjunction with antibiotics have been proposed to be beneficial in endophthalmitis management...
February 22, 2017: Cochrane Database of Systematic Reviews
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