Disruptive and dangerous behaviour by patients on acute psychiatric wards in three European centres

Issues in Mental Health Nursing

Allan

Simpson

et al. 2009

Self Cite

124

152

This is the accepted version of the paper.This version of the publication may differ from the final published version. to ascertain those factors most strongly associated with verbal aggression, aggression towards objects and physical aggression against others. High levels of aggression were associated with a high proportion of patients formally detained under mental health legislation, high patient turnover, alcohol use by patients, ward doors being locked, and higher staffing numbers (especially qualified nurses). The findings suggest that the imposition of restrictions on patients exacerbates the problem of violence, and that alcohol management strategies may be a productive intervention. Permanent repository linkInsufficient evidence is available to draw conclusions about the nature of the link between staffing numbers and violence.3

Section: Instrumentsmentioning

confidence: 99%

Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards

Issues in Mental Health Nursing

Allan

Simpson

et al. 2009

Self Cite

124

152

“…The Patient-staff Conflict Checklist (PCC-SR), an end of shift report by nurses on the frequency of conflict and containment events [13], was collected for a six month period on all participating wards. This form was also used to collect a limited amount of data on patients (age, gender, ethnicity, diagnosis, reason for admission, and postcode).…”

Section: Instrumentsmentioning

confidence: 99%

Morale is high in acute inpatient psychiatry

Allan

Simpson

et al. 2008

Soc Psychiat Epidemiol

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“…Reliable estimates for prevalence of these practices are hard to come by because their use varies markedly between countries and hospitals. A rare international comparison found no use of mechanical restraint for a sample of patients in England compared to half of patients in Greece and 10% of patients in Italy, but seclusion was most frequently used in England (1). However, there were significant differences in levels of containment between individual hospitals within countries.…”

Section: Introductionmentioning

confidence: 98%

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

Stewart

Merwe

Issues in Mental Health Nursing

et al. 2010

Self Cite

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link ObjectiveThis review examines nature and effectiveness of interventions to reduce the use of mechanical restraint and seclusion among adult psychiatric inpatients. MethodElectronic searches were conducted to locate post-1960 empirical studies of restraint and seclusion reduction in English. A total of 36 studies were identified, mostly from the USA. Analysis was conducted using a structured data extraction tool. ResultsThe majority of studies reported reduced levels or mechanical restraint and/or seclusion, but the standard of evidence was poor. There were no randomised trials.Most were retrospective studies of official records before and after the intervention was introduced, with varying follow-up periods. The interventions were diverse, but tended to include one or more of the following: new restraint and/or seclusion policies, staffing changes, staff training, review procedures and crisis management initiatives. The research was unable to address which of these elements was most effective. There was also evidence that some improved outcomes were achieved by substituting restraint or seclusion for each other or for alternatives forms of containment (medication in particular). Nurses' attitudes, skills and approach to patient care were absent from the literature. Conclusions 3Interventions probably can reduce the use of restraint and seclusion, but better designed research is required to demonstrate their effectiveness conclusively. More attention should also be paid to understanding how interventions work, particularly from the perspective of nursing staff. This is essential to the successful implementation of restraint and seclusion interventions across different psychiatric settings and treatment populations.4