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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
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
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
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
Shabnam Sood, Devna Rastogi, Gilbert Ramos, Napatkamon Ayutyanont
No abstract text is available yet for this article.
October 2017: Indian Journal of Psychiatry
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
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
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
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
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...
February 2, 2018: L'Encéphale
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...
December 11, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
Justin Maire, Carole Vincent-Monégat, Florent Masson, Anna Zaidman-Rémy, Abdelaziz Heddi
Many insects developing on nutritionally unbalanced diets have evolved symbiotic associations with vertically transmitted intracellular bacteria (endosymbionts) that provide them with metabolic components, thereby improving the host's abilities to thrive on such poor ecological niches. While host-endosymbiont coevolutionary constraints are known to entail massive genomic changes in the microbial partner, host's genomic evolution remains elusive, particularly with regard to the immune system. In the cereal weevil Sitophilus spp...
January 8, 2018: Microbiome
Eva Krieger, Steffen Moritz, Ricarda Weil, Matthias Nagel
Coercive interventions for psychiatric patients are controversial. Research on different preventive measures has increased over the last years. The present study examined patients' attitudes towards and understanding of previously experienced coercive measures as well as their preferences related to coercive measures and possible alternatives. In total, 213 patients who had experienced coercion and 51 patient controls (patients staying voluntarily on a closed ward with no coercive treatment) from three acute wards were examined via expert interviews and questionnaires in the framework of a naturalistic trial...
December 13, 2017: Psychiatry Research
Rika Eguchi, Daisuke Onozuka, Kouji Ikeda, Kenji Kuroda, Ichiro Ieiri, Akihito Hagihara
Objective Numerous studies on the effects of seclusion and/or restraint in acute psychiatric treatment have reported both positive and negative effects. However, no studies to date have evaluated the effects of seclusion and/or restraint on schizophrenia patients using a rating scale. Thus, to examine the effects of seclusion and/or restraint on schizophrenia patients, we used the Brief Psychiatric Rating Scale and assessed the psychological condition of patients. Methods Factor analysis was conducted to create subscales of Brief Psychiatric Rating Scale, and psychiatric changes were assessed with respect to each subscale using multiple logistic regression analyses...
January 1, 2017: International Journal of Psychiatry in Medicine
Robert E Harris, Jessica Richardson, Rosemary Frasso, Evan D Anderson
BACKGROUND: People who inject drugs (PWID) are at high risk for infectious diseases, skin and soft tissue infections, and overdose. However, these harms are all avoidable when sterile injection equipment, hygienic places to inject, and medical care are accessible. Unfortunately, many PWID in the U.S lack these resources. The most vulnerable are forced to inject in public spaces, where individual risks are high and communal harms are sometimes many. Supervised Injection Facilities (SIFs) are an established intervention for reducing these harms...
December 10, 2017: International Journal on Drug Policy
Chris Turner, Jake Turner
: Emergency medicine is widely recognised as an intense specialty. Interruptions are known to derail thoughts, increasing cognitive load and result in longer periods before deep thought is re-established. Although approachability and warmth are regarded as important factors in clinicians we wondered what impact these characteristics had on the number of interruptions. METHODOLOGY: A team of 6 medical students were trained in the use of abespoke tool to record shop floor activities. Over 4 months we conducted 100 hours of minute by minute time and motion study of emergency medicine consultants during their clinical shifts, and noted how often they were interrupted...
December 2017: Emergency Medicine Journal: EMJ
Sophia Sopromadze, Alexander Tsiskaridze
Violence is a significant public health problem representing one of the leading causes of death worldwide for people aged 15-44 years. Although violence and aggression are more frequent in adolescence and early adult life and decline with advancing age, these conditions can still develop for the first time in old age especially in association with organic brain disorder. Rates of violent death vary according to country income levels and are twice as higher in low- to middle-income countries than in high-income countries...
2018: Frontiers of Neurology and Neuroscience
Kim J Masters
No abstract text is available yet for this article.
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Owen Price, John Baker, Penny Bee, Karina Lovell
BACKGROUND: De-escalation techniques are recommended to manage violence and aggression in mental health settings yet restrictive practices continue to be frequently used. Barriers and enablers to the implementation and effectiveness of de-escalation techniques in practice are not well understood. OBJECTIVES: To obtain staff descriptions of de-escalation techniques currently used in mental health settings and explore factors perceived to influence their implementation and effectiveness...
January 2018: International Journal of Nursing Studies
Carlos Aguilera-Serrano, Jose Guzman-Parra, Juan A Garcia-Sanchez, Berta Moreno-Küstner, Fermin Mayoral-Cleries
OBJECTIVE: This systematic review presents evidence regarding factors that may influence the patient's subjective experience of an episode of mechanical restraint, seclusion, or forced administration of medication. METHOD: Two authors searched CINAHL, PubMed, SCOPUS, Web of Science, and Psych-Info, considering published studies between 1 January 1992 and 1 February 2016. Based on the inclusion criteria and methodological quality, 34 studies were selected, reporting a total sample of 1,869 participants...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
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