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Reducing seclusion and restraint in an acute adolescent psychiatric ward : A feasibility study
Lee-Aube, Angel Vakili, Alexandra Padhi, Ashwini Joseph, Sumithira Norcott, Julie Yap, Ann Keong
Lee-Aube, Angel
Vakili, Alexandra
Padhi, Ashwini
Joseph, Sumithira
Norcott, Julie
Yap, Ann Keong
Abstract
Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings.
Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility.
Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys.
Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service
delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit.
Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing.
Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended.
Keywords
restraint, risk management, seclusion and restraint, self-harm
Date
2023
Type
Journal article
Journal
Book
Volume
31
Issue
4
Page Range
451-461
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
File Access
Open
Notes
© 2023 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.