Developing a Restraint-Reduction Program for Child/ Adolescent Inpatient Treatment

Delaney, Kathleen R.

doi:10.1111/j.1744-6171.2001.tb00304.x

Cited by 23 publications

(30 citation statements)

References 73 publications

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“…Also discussed is how these measures are influenced by the overall unit functioning [5,18,20], changes to policy and procedures [5,19,21] and legal changes [2,22]. Concerns about seclusion and restraint use arise from clinicians, administrative staff and the wider community and success in decreasing seclusion and restraint rates is reported [5,17,21,23,24].…”

Section: Patterns Of Usementioning

confidence: 99%

Seclusion use with children and adolescents: an Australian experience

Fryer¹,

Beech²,

Byrne³

2004

Aust N Z J Psychiatry

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Section: Patterns Of Usementioning

confidence: 99%

Seclusion use with children and adolescents: an Australian experience

Fryer¹,

Beech²,

Byrne³

2004

Aust N Z J Psychiatry

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“…In other studies, nurses who saw restraint as unacceptable could find it difficult to choose between causing harm and promoting health (Ives & Melrose, 2010; Lloyd, Urquhart, Heard, & Kroese, 2008; McGrath & Huff, 2003). Delaney (2001) performed an ethical analysis of nurses’ perspectives on the harm of restraint versus the benefit in psychiatric settings and concluded that holding a child was perceived as “reasonable harm” compared with the benefit of the treatment.…”

Section: Introductionmentioning

confidence: 99%

Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians

Svendsen

Pedersen

Moen

et al. 2017

International Journal of Qualitative Studies on Health and Well

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The aim of this study was to explore nurses’ and physicians’ perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care.We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway.The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities.The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.

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“…As Wynaden et al (2001) point out, understanding staff perceptions, patient responses, and issues that led up to restraint could facilitate new ideas about aggression management. It is argued here that the United States should not embrace training formulas to the extent that the contextual factors of aggression management are ignored and opportunities for developing new management techniques missed (Delaney 2001).…”

Section: Resultsmentioning

confidence: 99%

Evidence Base for Practice: Reduction of Restraint and Seclusion Use During Child and Adolescent Psychiatric Inpatient Treatment

Delaney

2006

Worldviews Ev Based Nurs

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A B S T R A C TBackground: Restraint and seclusion of children has great potential for harm. Since the mid-1980s, psychiatric inpatient personnel for children and adolescents have put considerable energy in reducing the use of extreme measures of aggression management. While the use of restraints is a particular problem in the United States, aggression management and means of control in psychiatric settings is an international issue.Approach: The core question of this review was: What is the current state of the evidence supporting restraint reduction efforts with children and adolescents? Studies were reviewed and critiqued that related to programs of restraint reduction, restraint reduction methods, and aggression management. Internationally, there seems to be more emphasis on reducing coercive measures by understanding the context of their use. Thus, studies exploring staff perceptions and decisions concerning coercive measures were also examined.Findings: The evidence supporting restraint reduction methods in the United States comes mainly from case study reports of clinical sites' quality improvement projects. Consequently, a collection of studies is accumulating that supports a multi-strategy approach to restraint reduction. Limited evidence exists for aggression management measures and training in de-escalation techniques. Controversial aggression management techniques such as the use of pro re nata medication and holding continue to be used with very little support for their efficacy.Recommendations: Recommendations include taking a view of restraint and seclusion as emergency measures to address dangerous aggression, not interventions examined in controlled studies. As such it is suggested that sites pool data on restraint use and reduction efforts to create a database for benchmarking and studying variations among hospitals. Furthermore, attention should also be given to developing additional means for addressing aggressive behaviors.

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Developing a Restraint-Reduction Program for Child/ Adolescent Inpatient Treatment

Abstract: By combining what is known about child/adolescent restraint use with restraint-reduction research in the adult field, several options for restraint reduction can be derived.

Cited by 23 publications

References 73 publications

Seclusion use with children and adolescents: an Australian experience

Seclusion use with children and adolescents: an Australian experience

Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians

Evidence Base for Practice: Reduction of Restraint and Seclusion Use During Child and Adolescent Psychiatric Inpatient Treatment

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