Factors associated with the use of mechanical restraint in a mental health hospitalization unit: 8‐year retrospective analysis

Abstract

Introduction: Mechanical restraint is a controversial restrictive practice to manage agitation or violent behaviour. Numerous studies have evaluated the factors and organizational changes that influence on mechanical restraint, but only for short time periods. None of those studies have assessed the effects of measures applied within the framework of a long-term plan to reduce the use of mechanical restraint. Given the lack of specific legislation in Spain, more data are required for its proper regulation.

Relationship between nurses' use of verbal de‐escalation and mechanical restraint in acute inpatient mental health care: a retrospective study

“…This finding confirms that the risk of restraint is higher during the first days of admission (Pérez‐Revuelta et al . 2021); consequently, this justifies how important it is to establish a good nurse–patient therapeutic relationship as early as possible and thus be able to perform verbal de‐escalation in a timely manner in order to avoid mechanical restraint (Kuivalainen et al . 2017).…”

“…In order to reduce or eliminate the use of mechanical restraint, nurses use interventions aimed at addressing the patient in a state of agitation such as environmental or spatial restraint, pharmacological restraint, and verbal restraint or de‐escalation (Pérez‐Revuelta et al . 2021). Of these, verbal de‐escalation is the intervention that generates the most confidence, and thus it is considered the first psychomotor agitation control strategy (Hallett & Dickens 2017; Lavelle et al .…”

“…2020; Pérez‐Revuelta et al . 2021). Legislative changes and new regulations have started to emerge to prevent its use or restrict it to very extreme situations (Guzman‐Parra et al .…”

“…Reduction towards the elimination of mechanical restraint is a constant orientation for mental health services (Al-Maraira & Hayajneh 2019;McKeown et al 2020). In fact, many European countries are aligned with the USA and Australia in the interest of creating a legal framework to tend to reduce or even eliminate the use of mechanical restraint in mental health units (McKeown et al 2020;P erez-Revuelta et al 2021). Legislative changes and new regulations have started to emerge to prevent its use or restrict it to very extreme situations (Guzman-Parra et al 2016).…”

Factors associated with prolonged episodes of mechanical restraint in mental health hospitalization units in Andalusia

“…Andalusia is the most populous autonomous community in Spain, with more than eight million inhabitants. In Spain and Andalusia, there is a legal framework that regulates involuntary psychiatric admissions, but coercive measures are not specifically regulated (Pérez‐Revuelta et al., 2021). However, the mental healthcare system in Andalusia has undergone some changes over the past decade regarding the regulation and restriction of mechanical restraint, including the implementation of various initiatives designed to improve the quality of patient care and patient safety and the reduction of mechanical restraint (Guzman‐Parra et al, 2021).…”