Nurse and patient factors: Predicting seclusion in adolescent psychiatric units

Abstract

Problem Seclusion is considered a necessity when alternatives have failed. There is a consensus that seclusion has no therapeutic benefit, which justifies efforts to reduce the practice. This study aimed to identify nurse and patient variables that are predictive of seclusion on a large adolescent inpatient unit. Methods Nested case controls were used to compare 72 afternoon shifts on which seclusion occurred to 216 afternoon shifts on which no seclusion occurred, between 2010 and 2013, at an Adolescent Psychiatric Inpatient Unit. Findings Increased seclusion was predicted by a lower nurse to patient ratio, more male nurses on shift, fewer female nurses on shift, the presence of agency/temporary nurses on shift, greater combined years of mental health experience, and lower total HoNOSCA behavior subscale score. Unique predictors that increased risk of seclusion included greater number of male nurses and the presence of agency/temporary nurses, while a greater number of female nurses decreased risk of seclusion. Conclusions Nurses play a unique role in seclusion outcomes that are separate to patient‐factors and act as both protective and risk factors for seclusion. Changes can be made to staffing to reduce seclusion and future research should investigate why these nurse‐factors contribute to seclusion.

Cohort Study on the Effect of Psychological Education for Nurses in Psychiatric Department

“…In particular, nurses working in shift three have a long contact time with patients, fewer staff, heavy responsibilities, and a high level of mental stress for a long time, which will have a great impact on their physical and mental health [ 2 , 3 ]. Therefore, the occupational stress borne by nurses in psychiatric department was significantly higher than that of nurses in other departments [ 4 , 5 ].…”

The deployment of temporary nurses and its association with permanently-employed nurses’ outcomes in psychiatric hospitals: a secondary analysis

“…To date, studies investigating the effects of temporary nurses’ deployment have focused almost exclusively on acute somatic hospitals. Only one study analyzed temporary nurses in psychiatric hospitals, observing that the patients’ seclusion increased with higher deployments of temporary nurses ( Yurtbasi et al, 2021 ). Psychiatric hospitals differ substantially from somatic hospitals regarding the scope of their activity, their patient populations, and for their strong focus on risk assessment, especially for suicidality or deescalating interventions.…”