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https://www.readbyqxmd.com/read/29782230/minimizing-restraint-and-seclusion-in-schools-a-response-to-beaudoin-and-moore
#1
Virginia L Walker, Sarah E Pinkelman
Increasing efforts have been made in the field of special education to identify positive, evidence-based practices (EBPs) to meet the needs of students who engage in problem behavior, with a major goal being to eliminate or limit the use of reactive measures such as restraint and seclusion ( Snell & Walker, 2014 ). Various stakeholders, including families and self-advocates, have voiced concerns about the dangers of restraint and seclusion and the lack of protection afforded to students who engage in severe problem behavior...
June 2018: Intellectual and Developmental Disabilities
https://www.readbyqxmd.com/read/29782229/restraint-restrictive-intervention-and-seclusion-of-people-with-intellectual-and-developmental-disabilities
#2
Carli Friedman, Caitlin Crabb
Restraint, restrictive interventions, and seclusion are hotly contested practices with inconclusive evidence of their effectiveness. Because the use of restraint and seclusion on people with intellectual and developmental disabilities (IDD) is controversial and its effectiveness doubtable, this study was conducted to explore if and how they were permitted in Medicaid HCBS 1915(c) waivers, the largest providers of long-term services and supports (LTSS) for people with IDD. To do so, 111 fiscal year 2015 IDD waivers from across the nation were examined to determine if and how states permitted restraint, restrictive interventions, and seclusion...
June 2018: Intellectual and Developmental Disabilities
https://www.readbyqxmd.com/read/29720286/impact-of-brief-education-on-healthy-seniors-attitudes-and-healthcare-choices-about-alzheimer-s-disease-and-associated-symptoms
#3
Robyn E Waxman, Barbara J Russell, Oscar C T Iu, Benoit H Mulsant
ABSTRACTObjective:The primary objective of this study was to determine whether a brief education session about Alzheimer's disease (AD) stages and associated behavioral and psychological symptoms of dementia (BPSD) changes healthy seniors' treatment choices. A secondary objective was to determine whether pharmacotherapy to reduce BPSD would be preferred over other potentially more restrictive interventions. METHODS: Participants (n = 32; 8 men; aged > 64years; no self-reported dementia diagnosis) were assigned to one of ten group sessions during which they received information about AD and BPSD...
May 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29716447/trends-in-results-of-hbips-national-performance-measures-and-association-with-year-of-adoption
#4
Kenneth A Rasinski, Stephen P Schmaltz, Scott C Williams, David W Baker
OBJECTIVE: Multiple studies demonstrate a consistent pattern of improvement on quality measures among health care organizations after they begin collecting and reporting data. This study compared results on psychiatric performance measures among cohorts of hospitals with different characteristics that elected to begin reporting on the measures at various points in time. METHODS: Quarterly reporting of Hospital-Based Inpatient Psychiatric Services (HBIPS) measures to the Joint Commission was used to examine trends in performance among four hospital cohorts that began reporting in 2009 (N=243), 2011 (N=139), 2014 (N=137), or 2015 (N=372)...
May 2, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29707423/effects-of-statins-and-cholesterol-on-patient-aggression-is-there-a-connection
#5
Emily Leppien, Kimberly Mulcahy, Tammie Lee Demler, Eileen Trigoboff, Lewis Opler
Overview : Psychiatric adverse effects, including aggression, have been reported with the use of statin medications; however, there is little data to support or refute the theory that statins or low serum cholesterol do in fact increase a patient's risk of aggression. Objective : This study examined 1) statin use and increased aggression, measured by the requirement of either emergent psychiatric intervention referred to as "Code Green" (CG) or "Restraint and Seclusion" (RS) and 2) cholesterol level and increased aggression in psychiatric inpatients...
April 1, 2018: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/29698543/clinical-course-and-prevalence-of-coercive-measures-an-observational-study-among-involuntarily-hospitalised-psychiatric-patients
#6
Florian Hotzy, Sonja Moetteli, Anastasia Theodoridou, Andres Ricardo Schneeberger, Erich Seifritz, Paul Hoff, Matthias Jäger
AIMS OF THE STUDY: In daily clinical work, coercion continues to be highly prevalent, with rates differing between countries and sometimes even within countries or between wards of the same hospital. Previous research found inconsistent characteristics of individuals who underwent coercive measures during psychiatric treatment. Furthermore, there continues to be a lack of knowledge on the clinical course of people after being involuntarily committed. This study aimed to describe the rate and duration of different coercive measures and characterise a cohort of involuntarily committed patients regarding sociodemographic and clinical variables...
April 26, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29680485/-seclusion-and-mechanical-restraints-in-psychiatric-care-prescriptions-procedures-pharmacological-management-and-monitoring
#7
Chloé Tezenas du Montcel, Célia Kowal, Audrey Leherle, Soraya Kabbaj, Ariel Frajerman, Emmanuel Le Guen, Nora Hamdani, Franck Schürhoff, Marion Leboyer, Antoine Pelissolo, Baptiste Pignon
We will briefly summarize the French recommendations concerning the use of seclusion and mechanical restraint. Acute agitation and aggression or self-injurious activity during psychotic and manic episodes are the main indication of prescription of the coercive measures. Their prescriptions respect specific modalities that will be explained. Although they proved to be efficient, seclusion and restrain need to stay a last resort option, considering the risk of physical complications and psychological consequences...
April 18, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29662526/factors-predicting-length-of-stay-in-an-adolescent-psychiatric-unit-south-bronx-ny-a-short-report
#8
Muhammad Zeshan, Ahmed Waqas, Sadiq Naveed, Hamzah Ghulam, Pankaj Manocha
Objective: Mental health disorders account for around 1.8 million inpatient community hospital stays in the U.S.A. Our study aims to highlight the factors impacting the length of stay at a community hospital in the U.S.A. Methods: We reviewed 300 randomly selected charts to examine the factors impacting the length of stay in an adolescent inpatient psychiatric unit in 2011 and 2015. All data were analyzed in SPSS v. 20 with multiple regression analysis. Results: Longer length of stay among adolescents was associated with multiple psychiatric diagnoses, co-occurring medical comorbidities, not living with biological parents, history of mental illness, legal problems, substance use in the family, seclusion, restraints during current admission, and schizophrenia...
April 2018: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/29580706/-predictive-factors-of-seclusion-duration-in-patients-hospitalized-in-psychiatry-settings-a-prospective-multisite-study-in-the-dtrf-paris-sud
#9
J-F Costemale-Lacoste, V Cerboneschi, C Trichard, R De Beaurepaire, F Villemain, J-P Metton, C Debacq, T Ghanem, C Martelli, E Baup, E Loeb, P Hardy
INTRODUCTION: In psychiatric inpatient settings seclusion is a last resort to ensure the safety of the patient, other patients, and staff from disturbed behaviors. Despite its major interest for patients, seclusion could negatively impact treatment adherence and patient/staff relationships. Indeed, some secluded patients report a feeling of guilt during the measure and do not consider seclusion to be a healthcare intervention. To be more beneficial and to reduce the feeling by patients of being forced, seclusions should be as short and rare as possible...
March 23, 2018: L'Encéphale
https://www.readbyqxmd.com/read/29535651/reduced-frequency-of-cases-with-seclusion-is-associated-with-opening-the-doors-of-a-psychiatric-intensive-care-unit
#10
Lisa Hochstrasser, Alexander Voulgaris, Julian Möller, Tatjana Zimmermann, Regine Steinauer, Stefan Borgwardt, Undine E Lang, Christian G Huber
Background: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door status is still unclear. Aims: The aims of this study is to examine the transition from closed to predominantly open doors on a psychiatric intensive care unit (PICU) and its associations with the frequency of seclusion and forced medication...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29527618/long-term-impact-of-a-tailored-seclusion-reduction-program-evidence-for-change
#11
Patricia S Mann-Poll, Annet Smit, Eric O Noorthoorn, Wim A Janssen, Bauke Koekkoek, Giel J M Hutschemaekers
International comparative studies show that Dutch seclusion rates are relatively high. Therefore, several programs to change this practice were developed and implemented. The purpose of this study was to examine the impact of a seclusion reduction program over a long time frame, from 2004 until 2013. Three phases could be identified; the phase of development and implementation of the program (2004-2007), the project phase (2008-2010) and the consolidation phase (2011-2013). Five inpatient wards of a mental health institute were monitored...
March 12, 2018: Psychiatric Quarterly
https://www.readbyqxmd.com/read/29522590/-factors-associated-with-length-of-stay-and-the-risk-of-readmission-in-an-acute-psychiatric-inpatient-facility-a-retrospective-study
#12
Daniel Serrani, Gabriela Galfetti, Cinthia Rodríguez
OBJECTIVE: to investigate factors in?uencing length of stay and predictors for the risk of readmission at an acute psychiatric inpatient unit. METHOD: retrospective cross-sectional clinical fle audit ranging four years back, a random selection of 378 patients was reviewed, including 178 cases and 200 controls. A case control study was employed in the study of length of stay, and for predictors of risk of readmission a retrospective cohort study was used. RESULTS: the 7 variables that were associated with length of stay were: 1- instruction level, 2- place of origin, 3- use of restraints, 4- gender, 5- marital status, 6- drug class, and 7- number of visits...
July 2017: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/29521451/fear-and-blame-in-mental-health-nurses-accounts-of-restrictive-practices-implications-for-the-elimination-of-seclusion-and-restraint
#13
Eimear Muir-Cochrane, Deb O'Kane, Candice Oster
Restrictive practices continue to be used in mental health care despite increasing recognition of their harms and an international effort to reduce and ultimately eliminate their use. The aim of this qualitative study was to explore mental health nurses' views of the potential elimination of these practices. Nine focus groups were conducted with 44 mental health nurses across Australia, and the data analysed using thematic analysis. Overall, the nurses expressed significant fear about the potential elimination of restrictive practices and saw themselves as being blamed for both the use of these practices and the consequences should they be eliminated...
March 9, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29497205/does-exposure-to-a-seclusion-and-restraint-event-during-clerkship-influence-medical-student-s-attitudes-toward-psychiatry
#14
Shabnam Sood, Devna Rastogi, Gilbert Ramos, Napatkamon Ayutyanont
No abstract text is available yet for this article.
October 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/29488891/-restraints-in-greek-mental-health-services-ethics-practice-and-costs
#15
G Alevizopoulos, V Bozikas, C Touloumis
The use of physical and mechanical restraints in mental health services in Greece arise many ethical and practical issues. The justification of the use of such procedures is rather controversial and subjective to scientific debate. The practice of restraint puts both patients and staff at risk for injury and death. Moreover, restraints can be traumatic even when they do not result in any physical injury to the patient. The types of the physical adverse events include dehydration, suffocation, circulation disturbances, skin problems, loss of strength and mobility, incontinence, etc...
October 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29447413/effects-of-a-staff-training-intervention-on-seclusion-rates-on-an-adult-inpatient-psychiatric-unit
#16
Julie Newman, Olimpia Paun, Louis Fogg
The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes...
February 15, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29446553/children-s-moral-experiences-of-crisis-management-in-a-child-mental-health-setting
#17
Marjorie Montreuil, Catherine Thibeault, Linda McHarg, Franco A Carnevale
The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute...
February 15, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29431294/rapid-tranquilization-an-audit-of-irish-mental-health-nursing-practice
#18
Michael Nash, Caitriona McDonagh, Aisling Culhane, Imelda Noone, Agnes Higgins
Rapid tranquillization is a pharmacological intervention sometimes employed in mental health care for the management of acute behavioural disturbance. It is a form of restrictive practice, which, along with seclusion and restraint, is a conventional and controversial intervention in the therapeutic management of risk in mental health settings. This study surveyed mental health nurses practice in rapid tranquillization. A self-report questionnaire was utilized which addressed aspects such as definitions of rapid tranquillization, presence of rapid tranquillization policy, types of incidents where it is used and postintervention monitoring...
February 12, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29402385/-seclusion-and-restraint-from-prescription-to-decision
#19
T Mauras, A Perony, J Yadak, A Velasco, P Goudal, J-L Marcel
Psychiatric care has always included patients in crisis who are potentially dangerous or agitated. Faced with the many issues they may encounter, the therapeutic relationship has always been prioritized over all other considerations. However, the practice of seclusion and restraint has been steadily increasing in the past few decades. Their use is becoming customary rather than exceptional and consequently fosters less thought by the care teams. In the Healthcare System Modernization Act of January 26th, 2016, the lawmakers sought to underline the freedom-destroying nature of these practices and the necessity of their regulation...
March 11, 2018: L'Encéphale
https://www.readbyqxmd.com/read/29331599/long-term-reduction-of-seclusion-and-forced-medication-on-a-hospital-wide-level-implementation-of-an-open-door-policy-over-6-years
#20
L Hochstrasser, D Fröhlich, A R Schneeberger, S Borgwardt, U E Lang, R-D Stieglitz, C G Huber
BACKGROUND: Psychiatric inpatient treatment is increasingly performed in settings with locked doors. However, locked wards have well-known disadvantages and are ethically problematic. In addition, recent data challenges the hypothesis that locked wards provide improved safety over open-door settings regarding suicide, absconding and aggression. Furthermore, there is evidence that the introduction of an open-door policy may lead to short-term reductions in involuntary measures. The aim of this study was to assess if the introduction of an open-door policy is associated with a long-term reduction of the frequency of seclusion and forced medication...
February 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
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