Does the position of restraint of disturbed psychiatric patients have any association with staff and patient injuries?

Abstract

The aim of this study was to examine the risk of injury among patients and staff following involvement in a restraint episode in relation to restraint position (standing, supine or prone) and other aspects of the pre-incident behaviour including perceived causation. Mixed effects logistic regression was used to estimate the relative odds of injury to staff or patient in a series of 680 restraint episodes involving 260 patients in an adult mental health service in England between 1999 and 2001. There was no statistically significant association between patient injury and restraint position in this sample, but a prone restraint position was weakly associated with staff injury. Staff injury was most likely when an actual assault had occurred prior to the incident. Patient injury was more likely when the patient had self-harmed, had been abusing substances and had used a weapon prior to the incident, and less likely when the patient was showing signs of frustration with their environment. The use of prone restraint may be weakly associated with an increased risk of injury to staff. However, other aspects of the incident are stronger predictors and should be considered when planning training for front line staff.

Resident Aggression toward Staff at a Center for the Developmentally Disabled

“…Most staff reported being injured while physically restraining a resident. Research has shown that a common adverse consequence of physical restraint use is agitation of residents, and that combative residents often become more combative when restrained (Castle & Engberg, 2009;Driscoll, 1999;Lancaster, Whittington, Lane, Riley, & Meehan, 2008;Lee et al, 2003).…”

Deaths in custody: the role of restraint

“…In research in an acute mental health care trust the mean age for men involved in restraint incidents was 35.0 years (Lancaster et al, 2008). In statistics for restraint-related deaths, Stratton et al (2001) give the mean age as 31 years old, Grant et al (2007) as 38.5 years.…”

Factors Influencing Clinicians’ Attitudes about Aggression in Australian Acute Old Age Psychiatry Inpatient Units: A Cross Sectional Survey Design

“…A Cochrane Review of physical restraint, byM¨ohler et al (2011), concluded that restraint can have serious harmful physical and psychological effects on elderly patients. Physically restraining a patient also can culminate in injury to patients and staff involved in the procedure (Lancaster, Whittington, Lane, Riley, & Meehan, 2008;Stubbs, 2009). …”