Organizational and Unit Factors Contributing to Reduction in the Use of Seclusion and Restraint Procedures on an Acute Psychiatric Inpatient Unit

Abstract

Results indicated S/R use began showing a notable decrease corresponding to the time that senior unit management began discussions of the new JCAHO standards. These reductions maintained statistical significance even after controlling for changes in unit environmental variables.

Professionals’ Attitudes Toward Reducing Restraint: The Case of Seclusion in The Netherlands

“…Then it should be made clear if this reduction is actually feasible. Contrary to the views of most of the professionals themselves [12,33], an increase in the number of staff will not necessarily contribute to a reduction in seclusion [34], while in the opinion of many professionals, an increase in the number of interactions between professional and patient will actually contribute, as well as an improvement of interpersonal approach and ongoing reviewing of seclusion events [3,35,36]. Taking into account the positive fundamental attitude to formal restraint and the dislike of alternative interventions, it can be predicted that reduction will not be realized by means of one standardized order from management.…”

“…Restraint is frequently used in mental health care, despite it remains controversial [1][2][3]. As in many other western countries, also in the Netherlands we see a strong tendency to reduce restraint.…”

A Review of Interventions to Reduce Mechanical Restraint and Seclusion among Adult Psychiatric Inpatients

“…Reductions were found for violence and aggression (21,26,29), self-harm (21,26), staff injuries (29,37,41), and patient injuries (36,41). Some studies reported no change for these variables (20,30,32).…”

La médication psychiatrique comme contention : entre autonomie et protection, quelle place pour un cadre juridique ?

“…Pourtant, bien que la littérature scientifique sur l'isolement et les contentions soit abondante (Larue et al, 2009 ;Knutzen et al, 2007 ;Pollard et al, 2007), peu de chercheurs, de cliniciens, d'éthi -ciens ou de juristes s'intéressent à la question de la contention chimique (Currier, 2003).…”