AN ASSESSMENT OF THE USE OF SECLUSION AND RESTRAINT ON A PSYCHIATRIC CONTINUED TREATMENT UNIT.
Contributors: Union Institute (U.S.)
Published: 1990
Number of pages: 172
Subjects: Psychology, Clinical.; Health Sciences, Nursing.; Psychology, General.
Description: This study examined the use of seclusion and restraint on the Continued Treatment Unit of the John Umstead Hospital, Butner, N. C. The study investigated trends and use of seclusion and restraint over a six-month period.

Monthly seclusion and restraint data covered total hours per day, number of hours per episode by ward, total hours per ward, number of episodes per ward, frequency of less restrictive measures (1:1 and prn) used, and number of incidents by time of day. After six months of data was tallied, a chi-square test was run on nine of the factors tracked to discern significant relationships and trends.

Seclusion time was found to be highest on the second hospital shift between the hours of 2 pm to 6 pm. The females were secluded more frequently than the males. The males had longer number of hours per episode than the females. Once seclusion and restraint had been initiated, the patients tended to be left with restraints in use until the treatment termination, as opposed to going from seclusion with restraints to seclusion alone and then to termination of seclusion. It was found that there was an 80% chance that the patient would receive a form of less restrictive treatment such as 1:1 or prn medication prior to seclusion. The high management wards required the most hours per episode of seclusion treatment, with the male ward requiring the most time (4.2 hours per episode). When looking at all eleven wards, the male required an average of 9.4 hours of seclusion and the female required an average of 8.4 hours of seclusion per episode. No greater number of incidents of seclusion were found on weekdays than on weekends.

Late afternoon and shift changes are times for increased seclusion incidents. These time periods have less staff during the change of shift report (exchanged between clinicians), and less structured afternoon activities. This research supports the idea that seclusion and restraint are to be considered methods of helping the patient accept therapeutic treatment on a psychiatric ward. Seclusion and restraint remains a particularly effective therapy for the violent patient who cannot maintain self control on his or her own.
Notes: Source: Dissertation Abstracts International, Volume: 51-06, Section: B, page: 3153.

Thesis (PH.D.)--THE UNION INSTITUTE, 1990.

School code: 1033.