Seclusion in the Management of Highly Disturbed Children and Adolescents

Yurtbasi, Miriam K; Melvin, Glenn; Gordon, Michael S.

doi:10.1016/b978-0-12-804394-3.00013-9

Cited by 3 publications

(2 citation statements)

References 59 publications

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“…The behavior subscale on the Health of the Nation Outcome Scales for adults is predictive of seclusion (Jury et al, 2019), but our contrary findings are consistent with those of others who have reported that aggression was not the primary reason for seclusion (Keski‐Valkama et al, 2010; Yurtbasi et al, 2016). Adolescents are secluded for different reasons to adults and aggression is complex and defined differently among researchers (Allen et al, 2014; Doedens et al, 2019; Duke et al, 2014).…”

Section: Discussionsupporting

confidence: 91%

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Nurse and patient factors: Predicting seclusion in adolescent psychiatric units

Yurtbasi

Melvin

Pavlou

et al. 2021

Child Adoles Psych Nursing

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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.

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Section: Discussionsupporting

confidence: 91%

“…Factors selected for the logistic regression were based on significance in univariate analyses and on past research in adult psychiatric units for nurse variables (due to lack of adolescent specific research) and adolescent, child, and adult units for patient variables (Happell & Gaskin, 2011; Janssen et al, 2007; Yurtbasi et al, 2016).…”

Section: Methodsmentioning

confidence: 99%