Based on a modified grounded theory approach, in this study, we sought to elucidate the nursing care process used to guide psychiatric inpatients in long-term seclusion towards release from seclusion. Participant observations and interviews were conducted with a total of 18 nurses from three long-term psychiatric wards at two institutions from September 2011 to November 2012, to collect data on...

BACKGROUND The authors of a recent systematic review concluded that the use of non-pharmacological containment methods, excluding restraint and seclusion, was not supported by evidence. Their focus on randomised, controlled trials, however, does not reflect the research that has been, or could be, conducted. AIMS To find empirically supported interventions that allow reduction in the use of s...

BACKGROUND Involuntary medication in psychiatric treatment of inpatients is highly controversial. While laws regulating involuntary medication have been changed in Germany, no data have been available to date on how often involuntary medication is actually applied. Recently, our hospital group introduced specific routine documentation of legal status and application of involuntary medication in...

The objective of this study is to provide new knowledge and understanding of the decision making used throughout the seclusion process. Seven mental health nurses and one doctor were each interviewed within 48 hours of making the decision to seclude a patient. The interviews were analysed using content analysis. This study provides valuable information regarding factors that are central to, and...

Dr Zun has done an excellent job of reviewing the many controversies and complexities that surround the use of mechanical and chemical restraint as well as seclusion. He also shows us how many unanswered questions there are about such interventions. For example, an insightful psychiatric resident once raised the question of which intervention was more restrictive and stigmatizing: seclusion or ...

A total of 114 (31%) of 370 acute admissions to an inpatient unit over a one-year interval had at least one episode of seclusion or restraint. Four variables were significant predictors of seclusion and restraint. They were young age, diagnosis of borderline personality disorder, and two scores (irritability and total assets) on the Nurses Observation Scale for Inpatient Evaluation (NOSIE). Mor...

This resource document discusses the use of seclusion or restraint for purposes of mental health intervention in correctional facilities. Correctional mental health standards essentially state that seclusion or restraint, when used for health care purposes, should be implemented in a manner consistent with current community practice. The community practice was significantly impacted and revised...

We welcome the review by Gaskin et al 1 of interventions to reduce use of seclusion. Although studies reviewed were conducted in adult and child settings, the authors did not differentiate the developmental needs between these patient populations. The determinants of emotional distress and aggression may differ between children and adults. In adult psychiatric units, aggression is frequently as...

This study focussed on the relationship between the use of seclusion and staff characteristics, such as number of nurses on shift, male-female staff ratio, level of education and level of work experience. A retrospective analysis of staff characteristics was applied to administrative data from ten wards in four mid-sized general psychiatric hospitals in the Netherlands. The data show that two v...

This review examines the nature and effectiveness of interventions to reduce the use of mechanical restraint and seclusion among adult psychiatric inpatients. Thirty-six post-1960 empirical studies were identified. The interventions were diverse, but commonly included new restraint or seclusion policies, staffing changes, staff training, case review procedures, or crisis management initiatives....