Elements of Successful Restraint and Seclusion Reduction Programs and Their Application in a Large, Urban, State Psychiatric Hospital

Creedmoor Psychiatric Center and Columbia University College of Physicians and Surgeons, Queens Village, New York 11427, USA.
Journal of Psychiatric Practice (Impact Factor: 1.35). 02/2003; 9(1):7-15. DOI: 10.1097/00131746-200301000-00003
Source: PubMed

ABSTRACT In recent years, there has been a strong desire on the part of inpatient psychiatric programs to reduce the use of seclusion and mechanical restraint. There is a consensus among those who have published descriptions of successfully implemented restraint and seclusion reduction programs that the essential elements of such programs are high level administrative endorsement, participation by recipients of mental health services, culture change, training, data analysis, and individualized treatment. This article describes these elements and their application in a successful restraint reduction program at Creedmoor Psychiatric Center, a large, urban, state-operated psychiatric hospital that reduced its combined restraint and seclusion rate by 67% over a period of 2 years.

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    • "Consequently , there has been a worldwide move toward the reduction or elimination of both restraint and other containment practices, such as seclusion, in mental health care (Department of Health 2008; Te Pou 2008). Effective initiatives to reduce restraint are described in the published work (Evans et al. 2002; Fisher 2003), but there remain variations in use and attitudes towards containment measures (Bowers et al. 2007), and the need for organizational and philosophical shifts in restraint reduction efforts have been identified (Ashcraft & Anthony 2008). "
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    • "Nurses were instructed to rate each coercive measure for each day separately. The exact time of the start and the end of each coercive measure was also entered in the database, allowing the calculation of episodes (Fisher, 2003). "
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