The use of restraint in four general hospital emergency departments in Australia

Gerace, Adam; Pamungkas, Dewi R; Oster, Candice; Thomson, Del; Muir‐Cochrane, Eimear

doi:10.1177/1039856214534001

Cited by 20 publications

(16 citation statements)

References 15 publications

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“…Similarly, Gerace et al . () found 90% of patients mechanically restrained in ED had a mental health diagnosis and called for further mental health professional expertise within all EDs. In addition to extra nursing positions another role that may contribute to more effective care is that of a peer support person.…”

Section: Discussionmentioning

confidence: 99%

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Australian nurses' perceptions of the use of manual restraint in the Emergency Department: a qualitative perspective

Chapman

Ogle

Martin

et al. 2016

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 99%

“…Patients at risk of being manually restrained in the Emergency Department (ED) include those with severe psychiatric illnesses (Gerace et al . ) and increasing numbers of patients with dementia (Jones et al . ).…”

Section: Introductionmentioning

confidence: 99%

Australian nurses' perceptions of the use of manual restraint in the Emergency Department: a qualitative perspective

Chapman

Ogle

Martin

et al. 2016

Journal of Clinical Nursing

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“…Despite overwhelming support for reducing and eliminating the use of seclusion and restraint, and the success of reduction programs, these practices continue to be used in mental health care (Allan et al 2017;Bowers et al 2017;Bullock et al 2014;Gerace et al 2014;Muir-Cochrane et al 2014;Oster et al 2016;Te Pou o te Whakaaro Nui, 2017). Mental health nurses play a central role in the provision of mental health care and as such represent the staff that are most likely to use seclusion and restraint (NMHCCF, 2009).…”

Section: Introductionmentioning

confidence: 99%

Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint

Muir‐Cochrane

O’Kane

Oster

2018

Int J Mental Health Nurs

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117

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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. Findings detail the conflicts facing staff in balancing the need for ward safety for everyone present while at the same time providing person-centred care. Nurses described the changing role of the mental health nurse in acute settings, being more focussed on risk assessment and medication while at the same time attempting to practise in trauma-informed person-centred ways. The impact on ward safety with increasing acuity of consumers plus the presence of forensic consumers and those affected by methamphetamine was emphasized. Change initiatives need to take into account nurses' deep concerns about the consequences of eliminating all forms of control measures in hospitals and respond to the symptoms and behaviours consumers present with and associated unpredictable and concerning behaviours. Attempts to eliminate restrictive practices should, therefore, be carefully considered and come with a clear articulation of alternatives to ensure the safety of consumers, visitors, and staff.

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“…1 In Australia, serious concerns about the use of seclusion and restraint in mental health care have been raised at least since 1993, 2 and in 2005 all Australian health ministers agreed to reduce the use of seclusion and restraint. 3 Several studies have noted adverse consequences for those subjected to seclusion and mechanical restraint [4][5][6][7][8][9] and raised concerns with human rights breaches. 10 Many mental health practitioners, consumers and family members, friends and other supporters (supporters) have also embraced the aim to reduce and, where possible, eliminate seclusion and restraint.…”

Section: Introductionmentioning

confidence: 99%

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Brophy

Roper²,

Hamilton

et al. 2016

Aust. Health Review

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Objective. This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings.Methods. Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.Results. All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes.Conclusions. Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices.What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies. What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature.

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The use of restraint in four general hospital emergency departments in Australia

Cited by 20 publications

References 15 publications

Australian nurses' perceptions of the use of manual restraint in the Emergency Department: a qualitative perspective

Australian nurses' perceptions of the use of manual restraint in the Emergency Department: a qualitative perspective

Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

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