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https://www.readbyqxmd.com/read/28421661/safety-in-psychiatric-inpatient-care-the-impact-of-risk-management-culture-on-mental-health-nursing-practice
#1
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
#2
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
#3
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
#4
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
#5
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
#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/28368091/de-escalation-techniques-for-psychosis-induced-aggression-or-agitation
#7
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
#8
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...
March 29, 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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28138979/an-evaluation-of-the-use-and-efficacy-of-a-sensory-room-within-an-adolescent-psychiatric-inpatient-unit
#14
Monique West, Glenn Melvin, Francis McNamara, Michael Gordon
BACKGROUND/AIM: The introduction of sensory rooms within acute psychiatric settings provides a therapeutic space that promotes emotional self-regulation and reduces distress and disruptive behaviours. The current research investigated the clinical benefit of a sensory room within an adolescent psychiatric unit. It examined whether guided sensory room use can reduce distress for adolescents and identified characteristics of sensory room users. Seclusion rates 12 months pre- and post-sensory room introduction were compared...
January 31, 2017: Australian Occupational Therapy Journal
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
#15
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
#16
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/28077156/interventions-following-a-high-violence-risk-assessment-score-a-naturalistic-study-on-a-finnish-psychiatric-admission-ward
#17
Jenni Kaunomäki, Markus Jokela, Raija Kontio, Tero Laiho, Eila Sailas, Nina Lindberg
BACKGROUND: Patient aggression and violence against staff members and other patients are common concerns in psychiatric units. Many structured clinical risk assessment tools have recently been developed. Despite their superiority to unaided clinical judgments, staff has shown ambivalent views towards them. A constant worry of staff is that the results of risk assessments would not be used. The aims of the present study were to investigate what were the interventions applied by the staff of a psychiatric admission ward after a high risk patient had been identified, how frequently these interventions were used and how effective they were...
January 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28060434/participatory-bioethics-research-and-its-social-impact-the-case-of-coercion-reduction-in-psychiatry
#18
Tineke A Abma, Yolande Voskes, Guy Widdershoven
In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes are tailored to the interests and context, and the type of impact stakeholders envisage...
February 2017: Bioethics
https://www.readbyqxmd.com/read/28000422/secondary-analysis-of-data-can-inform-care-delivery-for-indigenous-women-in-an-acute-mental-health-inpatient-unit
#19
Pat Bradley, Teresa Cunningham, Anne Lowell, Tricia Nagel, Sandra Dunn
There is a paucity of research exploring Indigenous women's experiences in acute mental health inpatient services in Australia. Even less is known of Indigenous women's experience of seclusion events, as published data are rarely disaggregated by both indigeneity and gender. This research used secondary analysis of pre-existing datasets to identify any quantifiable difference in recorded experience between Indigenous and non-Indigenous women, and between Indigenous women and Indigenous men in an acute mental health inpatient unit...
December 21, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27992811/seclusion-and-enforced-medication-in-dealing-with-aggression-a-prospective-dynamic-cohort-study
#20
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
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