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https://www.readbyqxmd.com/read/28886752/protocol-for-the-management-of-psychiatric-patients-with-psychomotor-agitation
#1
Eduard Vieta, Marina Garriga, Laura Cardete, Miquel Bernardo, María Lombraña, Jordi Blanch, Rosa Catalán, Mireia Vázquez, Victòria Soler, Noélia Ortuño, Anabel Martínez-Arán
BACKGROUND: Psychomotor agitation (PMA) is a state of motor restlessness and mental tension that requires prompt recognition, appropriate assessment and management to minimize anxiety for the patient and reduce the risk for escalation to aggression and violence. Standardized and applicable protocols and algorithms can assist healthcare providers to identify patients at risk of PMA, achieve timely diagnosis and implement minimally invasive management strategies to ensure patient and staff safety and resolution of the episode...
September 8, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28866330/aggression-and-violence-in-psychiatric-hospitals-with-and-without-open-door-policies-a-15-year-naturalistic-observational-study
#2
Andres R Schneeberger, Eva Kowalinski, Daniela Fröhlich, Katrin Schröder, Stefanie von Felten, Martin Zinkler, Karl H Beine, Andreas Heinz, Stefan Borgwardt, Undine E Lang, Donald A Bux, Christian G Huber
Aggressive behavior and violence in psychiatric patients have often been quoted to justify more restrictive settings in psychiatric facilities. However, the effects of open vs. locked door policies on aggressive incidents remain unclear. This study had a naturalistic observational design and analyzed the occurrence of aggressive behavior as well as the use of seclusion or restraint in 21 German hospitals. The analysis included data from 1998 to 2012 and contained a total of n = 314,330 cases, either treated in one of 17 hospitals with (n = 68,135) or in one of 4 hospitals without an open door policy (n = 246,195)...
August 26, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28840930/trauma-informed-care-and-practice-practice-improvement-strategies-in-an-inpatient-mental-health-ward
#3
Paul Beckett, Douglas Holmes, Monique Phipps, Declan Patton, Luke Molloy
A growing body of evidence highlights that trauma is the single most significant predictor that an individual will need support from mental health services. Yet despite this association, mental health services have been slow to provide approaches to care and treatment that deal directly with trauma. Embedding the principles of trauma-informed care and practice (TICP) in acute inpatient ward practice can lead to practice improvement and cultural change over a number of areas. The current service evaluation highlights how these principles can inform practice and the positive affect this has on areas such as seclusion and restraint, therapeutic engagement, and ward routines...
August 24, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28797822/mental-health-nurses-emotions-exposure-to-patient-aggression-attitudes-to-and-use-of-coercive-measures-cross-sectional-questionnaire-survey
#4
Rahul Jalil, Jorg W Huber, Judith Sixsmith, Geoffrey L Dickens
BACKGROUND: Mental health nurses are exposed to patient aggression, and required to manage and de-escalate aggressive incidents; coercive measures such as restraint and seclusion should only be used as a last resort. An improved understanding of links between nurses' exposure to aggression, attitudes to, and actual involvement in, coercive measures, and their emotions (anger, guilt, fear, fatigue, sadness), could inform preparation and education for prevention and management of violence...
July 31, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28793087/experiences-of-adolescent-crack-users-and-their-relatives-with-psychosocial-care-and-institucionalization
#5
Milena Lima de Paula, Maria Salete Bessa Jorge, Leilson Lira de Lima, Indara Cavalcante Bezerra
The Drug User Comprehensive Care Policy establishes that care practices should cover biopsychosocial realms. However, evidence reveals an institutionalized practice, in which families prioritize the subject's seclusion from its context of use. This study aimed to understand the implications of psychosocial care and institutionalization in meeting the needs of adolescent crack users and their families. Eleven teenagers and six relatives narrated their experiences through in-depth interviews, which were analyzed in the light of Paul Ricoeur's Phenomenological Hermeneutics...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28758344/characterizing-the-inpatient-care-of-young-adults-experiencing-early-psychosis-a-medical-record-review
#6
Joseph H Puyat, Renata Kamieniecki, Brenda Vaughan, Tamara Mihic, Kofi Bonnie, Jeffrey Danielson, Sierra Williams
AIM: To characterize the inpatient care received by individuals experiencing early psychotic episodes in an inner city hospital. METHOD: Medical records of patients admitted between April 01, 2013, and March 31, 2015, to a psychiatric ward at an inner city hospital were retrospectively examined. Included in the study are patients who were 25 years of age or younger and were hospitalized for psychotic symptoms. Demographics and health service use were summarized using descriptive statistics...
July 31, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28719249/applying-sensory-modulation-to-mental-health-inpatient-care-to-reduce-seclusion-and-restraint-a-case-control-study
#7
Charlotte Andersen, Anne Kolmos, Kjeld Andersen, Volkmar Sippel, Elsebeth Stenager
BACKGROUND: Clinical training in managing conflicts and preventing violence seldom contains sensory modulation (SM) as a method to de-escalate and prevent restraint and seclusion. Sensory-based interventions promote adaptive regulation of arousal and emotion. SM is a complementary approach that is associated with reduced rates of seclusion and restraint in mental healthcare, but there is need for more research in this area. AIMS: Using SM to reduce restraint and seclusion in inpatient mental health care...
July 18, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28653508/evaluation-of-the-use-of-a-sensory-room-on-an-adolescent-inpatient-unit-and-its-impact-on-restraint-and-seclusion-prevention
#8
Angela Seckman, Olimpia Paun, Biljana Heipp, Marie Van Stee, Vonda Keels-Lowe, Frank Beel, Cari Spoon, Louis Fogg, Kathleen R Delaney
TOPIC: Restraint and seclusion (R/S) reduction initiatives require multimodal efforts, particularly proactive approaches to facilitate patients' regulation. Sensory approaches are an increasingly popular method for helping patients self-regulate. A plan-do-check-act quality improvement model was used to measure practical aspects of a newly implemented sensory room on an adolescent psychiatric inpatient unit. PURPOSE: This article describes an adolescent unit's implementation processes and methods used to evaluate a sensory room and its impact on R/S use, staff-patient relationships, and patients' aggressive behaviors...
June 27, 2017: Journal of Child and Adolescent Psychiatric Nursing
https://www.readbyqxmd.com/read/28635150/a-pilot-study-of-post-seclusion-and-or-restraint-review-intervention-with-patients-and-staff-in-a-mental-health-setting
#9
Marie-Hélène Goulet, Caroline Larue, Ashley J Lemieux
PURPOSE: To develop and evaluate a "post-seclusion and/or restraint review" (PSRR) intervention implemented in an acute psychiatric care unit. DESIGN AND METHODS: Twelve staff members and three patients were enrolled in a participatory case study. To evaluate PSRR intervention, qualitative analysis was carried out. Seclusion and restraint use 6 months before and after the PSRR implementation was compared. FINDINGS: Nurses reported that they were able to explore the patient's feelings during the PSRR intervention with patients, which led to restoration of the therapeutic relationship...
June 20, 2017: Perspectives in Psychiatric Care
https://www.readbyqxmd.com/read/28629613/out-of-the-institution-into-the-classroom-legal-challenges-to-the-use-of-restraint-and-seclusion-in-school-settings-in-the-united-states
#10
Lycette Nelson
The issue of restraint and seclusion of children with mental and developmental disabilities in schools has gained greater attention in the United States in recent years as more children with disabilities are attending mainstream schools. This article looks at how cases brought on behalf of children who have been subjected to such treatment fit or fail to fit within a well-developed jurisprudence that provides constitutional protections for the rights of people with mental disabilities to be free from discrimination and from cruel and unusual punishment...
July 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/28611886/managing-acute-behavioural-disturbances-in-the-emergency-department-using-the-environment-policies-and-practices-a-systematic-review
#11
Tracey J Weiland, Sean Ivory, Jennie Hutton
INTRODUCTION: Effective strategies for managing acute behavioural disturbances (ABDs) within emergency departments (EDs) are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28608713/a-case-study-seclusion-and-restraint-in-psychiatric-care
#12
Marie-Hélène Goulet, Caroline Larue
A wide breadth of research has recognized that seclusion and restraint affects patients, staff, and organizations alike. Therefore, it is essential to understand the viewpoints of all stakeholders to improve practices. The study aimed to understand the context in which seclusion and restraint practices are employed based on the perceptions of staff and inpatients in a psychiatric ward. A case study was performed using a participatory approach. Methods included a 56-hr immersion in the practice setting and individual interviews with staff and patients ( n = 17)...
June 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28595808/regulating-seclusion-and-restraint-in-health-care-settings-the-promise-of-the-convention-on-the-rights-of-persons-with-disabilities
#13
Bernadette McSherry
No abstract text is available yet for this article.
July 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/28583103/in-patient-costs-of-agitation-and-containment-in-a-mental-health-catchment-area
#14
Antoni Serrano-Blanco, Maria Rubio-Valera, Ignacio Aznar-Lou, Luisa Baladón Higuera, Karina Gibert, Alfredo Gracia Canales, Lisette Kaskens, José Miguel Ortiz, Luis Salvador-Carulla
BACKGROUND: There is a scarce number of studies on the cost of agitation and containment interventions and their results are still inconclusive. We aimed to calculate the economic consequences of agitation events in an in-patient psychiatric facility providing care for an urban catchment area. METHODS: A mixed approach combining secondary analysis of clinical databases, surveys and expert knowledge was used to model the 2013 direct costs of agitation and containment events for adult inpatients with mental disorders in an area of 640,572 adult inhabitants in South Barcelona (Spain)...
June 6, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28506820/seasonal-variation-of-hospital-violence-seclusion-and-restraint-in-a-forensic-psychiatric-hospital
#15
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
#16
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
#17
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
#18
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...
July 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28457209/patients-experiences-of-restrictive-interventions-in-australia-findings-from-the-2010-australian-survey-of-psychosis
#19
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
#20
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
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