Compliance With Less Restrictive Aggression-Control Procedures

Glynn, Shirley M.; Bowen, Linda; Marshall, Barringer D.; Banzett, Lorelle K.

doi:10.1176/ps.40.1.82

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…Education Programs for Restraint Reduction (60) As a result of research, we know that staff training in the prediction and prevention of restraint and/or seclusion use can reduce overall seclusion and restraint rates, inappropriate restraint and seclusion, and staff and patient injury. Several kinds of educational programs have been successfully used to reduce the use of restraints and seclusion [106].…”

Section: Least Restrictive Alternatives To the Use Of Restraints And mentioning

confidence: 99%

A Synthesis of What We Know About the Use of Physical Restraints and Seclusion with Patients in Psychiatric and Acute Care Settings: 2003 Update

Bower

McCullough²,

Timmons³

2003

Worldviews on Evidence-based Nursing presents the archives of O

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Purpose (1) This article is an update of the January 19, 2000, Volume 7, Number 2 article of the synthesis of research findings on the use of restraint and seclusion with patients in psychiatric and acute care settings. Conclusions (2) The little that is known about restraint/seclusion use with these populations is inconsistent. Attitudes and perceptions of patients, family, and staff differ. However, all patients had very negative feelings about both, whether they were restrained/secluded or observed by others who were not restrained. The reasons for restraint/seclusion use vary with no accurate use rate for either. What precipitates the use of restraint/seclusion also varies, but professionals claim they are necessary to prevent/treat violent or unruly behavior. Some believe seclusion/restraint is effective, but there is no empirical evidence to support this belief. Many less restrictive alternatives have been tested with varying outcomes. Several educational programs to help staff learn about different ways to handle violent/confused patients have been successful. Implications (3) Until more is known about restraint/seclusion use from prospective controlled research, the goal to use least restrictive methods must be pursued. More staff educational programs must be offered and the evaluation of alternatives to restraint/seclusion pursued. When seclusion/restraint is necessary, it should be used less arbitrarily, less frequently, and with less trauma. As the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Health Care Financing Administration (HCFA) have prescribed, “Seclusion and restraint must be a last resort, emergency response to a crisis situation that presents imminent risk of harm to the patient, staff, or others” (p. 25) [99A].

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Section: Least Restrictive Alternatives To the Use Of Restraints And mentioning

confidence: 99%

A Synthesis of What We Know About the Use of Physical Restraints and Seclusion with Patients in Psychiatric and Acute Care Settings: 2003 Update

Bower

McCullough²,

Timmons³

2003

Worldviews on Evidence-based Nursing presents the archives of O

View full text Add to dashboard Cite

show abstract

“…Some studies exist that have shown decreases in the frequency of problematic behaviors, following treatment with brief timeout (Barton, Brulle, & Repp, 1987;Roberts, 1988;Sherburne et a/., 1988;White & Bailey, 1990), but these studies did not attempt to assess the relative value of any particular timeout duration. The trend in both published treatment studies and research directed toward addressing the duration issue specifically, has been that 'more is better' (see Benjamin et al, 1983, Foxx et al, 1980, and Glynn, Bowen, Marshall, & Banzett, 1989. Longer durations have been viewed as more punitive and, therefore, more effective (Garrison et al, 1989;Hafner et al, 1989;Kalogiera et al, 1989).…”

Section: Discussionmentioning

confidence: 99%

The effect of timeout duration on frequency of aggression in hospitalized children with conduct disorders

McGuffin

1991

Behavioral Interventions

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Timeout has been shown to be an effective procedure in the treatment of aggressive behaviors. Previous research, however, has not provided evidence to support the use of a particular timeout duration in the treatment of aggressive behavior. This study compared the effectiveness of four different timeout durations (1, 5, 10, and 20 min) in the treatment of aggressive behavior in hospitalized children with conduct disorders. Results did not support the use of extended periods of timeout, but suggested that 5 min duration was as or more effective than the other tested durations.Timeout is a widely utilized and widely researched technique in the treatment of a variety of problematic behaviors. Brantner and Doherty (1983), in a comprehensive review, discuss the wide range of problematic behaviors which have been treated through the use of timeout. Their discussion gives examples of the use of timeout in a variety of settings, with extremely diverse populations. Timeout has been used in school settings (Ahern,

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“…For instance, in a retrospective Canadian study that analyzed reasons for restraint use and examined least restrictive alternatives in a long-term care setting, no specific alternatives to restraints were offered although the respondents acknowledged the importance of assessing patients, their environments and their caregivers [157]. Other studies have demonstrated that some nurses know about and use a variety of least restrictive alternatives successfully [60,167,210]. Long-term care nurses have been able to recommend alternatives to restraint and have been very creative in their approaches [80].…”

Section: Least Restrictive Alternatives To the Use Of Restraints And mentioning

confidence: 99%

A Synthesis of What We Know About the Use of Physical Restraints and Seclusion with Patients in Psychiatric and Acute Care Settings

Bower¹,

McCullough²,

Timmons³

2000

Worldviews on Evidence-based Nursing presents the archives of O

View full text Add to dashboard Cite

Purpose (1) This article synthesizes research findings on the use of restraint and seclusion with patients in psychiatric and acute care settings. Conclusions (2) The little that is known about restraint/seclusion use with these populations is inconsistent. Attitudes and perceptions of patients, family, and staff differ. However, all patients had very negative feelings about both, whether they were restrained/secluded or observed by others who were not restrained. The reasons for restraint/seclusion use vary with no accurate use rate for either. What precipitates the use of restraint/seclusion also varies but professionals claim they are necessary to prevent/treat violent or unruly behavior. Some believe seclusion/restraint is effective but there is no empirical evidence to support this belief. Many less restrictive alternatives have been tested with varying outcomes. Several educational programs to help staff learn about different ways to handle violent/confused patients have been successful. Implications (3) Until more is known about restraint/seclusion use from prospective controlled research, the goal to use least restrictive methods must be pursued. More staff educational programs must be offered and the evaluation of alternatives to restraint/seclusion pursued. When seclusion/restraint is necessary it should be used less arbitrarily, less frequently, and with less trauma.

show abstract

Compliance With Less Restrictive Aggression-Control Procedures

Cited by 7 publications

References 8 publications

A Synthesis of What We Know About the Use of Physical Restraints and Seclusion with Patients in Psychiatric and Acute Care Settings: 2003 Update

A Synthesis of What We Know About the Use of Physical Restraints and Seclusion with Patients in Psychiatric and Acute Care Settings: 2003 Update

The effect of timeout duration on frequency of aggression in hospitalized children with conduct disorders

A Synthesis of What We Know About the Use of Physical Restraints and Seclusion with Patients in Psychiatric and Acute Care Settings

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