Rethinking restraint use during pediatric mental health hospitalizations

Abstract

In this issue of Journal of Hospital Medicine, Wolf et al. 1 analyzes variation in pharmacologic restraint use during pediatric mental health hospitalizations across 49 children's hospitals. Using claims data from the Pediatric Hospital Information System database, the use of pharmacologic restraints varied widely, ranging from 6 to 282 days with pharmacologic restraint use per 1000 mental health bed days. Significant variation persisted across hospitals after adjusting for differences in the sociodemographic and clinical characteristics of hospitalized children. Three hospitals were classified as high utilizers of all classes of pharmacologic restraints, while 22 hospitals were medium utilizers of one to two pharmacologic classes and 24 hospitals were low utilizers of pharmacologic restraints. These