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Pettit, Sophie A; Bowers, Len; Tulloch, Alex; Cullen, Alexis E.; Moylan, Lois Biggin; Sethi, Faisil; McCrone, Paul; Baker, John; Quirk, Alan; Stewart, Duncan (2017)
Publisher: John Wiley and Sons Inc.
Languages: English
Types: Article
Subjects: seclusion, containment, mental health nursing, Mentalhealth, psychiatric care, psychology, Original Research: Empirical Research – Quantitative, RESEARCH PAPERS, nursing, manual restraint
Aims\ud \ud The aim of this study was to compare across different service configurations the acceptability of containment methods to acute ward staff and the speed of initiation of manual restraint.\ud \ud Background\ud \ud One of the primary remits of acute inpatient psychiatric care is the reduction in risks. Where risks are higher than normal, patients can be transferred to a psychiatric intensive care unit or placed in seclusion. The abolition or reduction in these two containment methods in some hospitals may trigger compensatory increases in other forms of containment which have potential risks. How staff members manage risk without access to these facilities has not been systematically studied.\ud \ud Design\ud \ud The study applied a cross-sectional design.\ud \ud Methods\ud \ud Data were collected from 207 staff at eight hospital sites in England between 2013 - 2014. Participants completed two measures; the first assessing the acceptability of different forms of containment for disturbed behaviour and the second assessing decision-making in relation to the need for manual restraint of an aggressive patient.\ud \ud Results\ud \ud In service configurations with access to seclusion, staff rated seclusion as more acceptable and reported greater use of it. Psychiatric intensive care unit acceptability and use were not associated with its provision. Where there was no access to seclusion, staff were slower to initiate restraint. There was no relationship between acceptability of manual restraint and its initiation.\ud \ud Conclusion\ud \ud Tolerance of higher risk before initiating restraint was evident in wards without seclusion units. Ease of access to psychiatric intensive care units makes little difference to restraint thresholds or judgements of containment acceptability.
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    • Abderhalden C., Needham I., Dassen T., Halfens R., Hans-Joachim H. & Fisher J. (2008) Structured risk assessment and violence in acute psychiatric wards: randomised controlled trial. The British Journal of Psychiatry 193, 44-50.
    • Alty A. (1997) Nurses' learning experience and expressed opinions regarding seclusion practice within one NHS trust. Journal of Advanced Nursing 25(4), 786-793.
    • Bowers L. (2006) On conflict, containment and the relationship between them. Nursing Inquiry 13(3), 172-180.
    • Bowers L., Crowhurst N., Alexander J., Eales S., Guy S. & McCann E. (2003) Psychiatric nurses' views on criteria for psychiatric intensive care: acute and intensive care staff compared. International Journal of Nursing Studies 40(2), 145- 152.
    • Bowers L., Alexander J., Simpson A., Ryan C. & Carp-Walker P. (2004) Cultures of psychiatry and the professional socialization process: the case of containment methods for disturbed patients. Nurse Education Today 24(6), 435-442.
    • Bowers L., Alexander J., Simpson A., Ryan C. & Carp-Walker P. (2007a) Student psychiatric nurses' approval of containment measures: relationship to perception of aggression and attitudes to personality disorder. International Journal of Nursing Studies 44, 349-356.
    • Bowers L., Van Der Werf B., Vokkolainen A., Muir-Cochraned E., Allana T. & Alexander J. (2007b) International variation in attitudes to containment measures for disturbed psychiatric inpatients. International Journal of Nursing Studies 44, 357-364.
    • Bowers L., Van Der Merwe M., Nijman H., Hamilton B., Noorthorn E., Stewart D. & Muir-Cochrane E. (2010) The practice of seclusion and time-out on English acute psychiatric wards: the City-128 study. Archives of Psychiatric Nursing 24 (4), 275-286.
    • Bowers L., Hammond N., James K., Quirk A., Robson D. & Stewart D. (2012a) Characteristics of acute wards associated with the presence of a psychiatric intensive care unit and transfers of patients to it. Journal of Psychiatric Intensive Care 8 (2), 66-77.
    • Bowers L., Ross J., Nijman H., Muir-Cochrane E., Noorthorn E. & Stewart D. (2012b) The scope for replacing seclusion with time out in acute inpatient psychiatry in England. Journal of Advanced Nursing 68(4), 826-835.
    • Bowers L., James K., Quirk A., Simpson A., Stewart D. & Hodsoll J. (2015) Reducing conflict and containment rates on acute psychiatric wards: the Safewards cluster randomised controlled trial. International Journal of Nursing Studies 52(9), 1412-1422.
    • Cashin A. (1996) Seclusion: the quest to determine effectiveness. Journal of Psychosocial Nursing and Mental Health Services 34 (11), 17-21.
    • Dack C., Ross J. & Bowers L. (2012) The relationship between attitudes towards different containment measures and their usage in a national sample of psychiatric inpatients. Journal of Psychiatric and Mental Health Nursing 19(7), 577-586.
    • Department of Health (2002) Mental Health Policy Implementation Guide: National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units and Low Secure Environments. Department of Health, London.
    • Department of Health (2015) Mental Health Act 1983: Code of Practice. The Stationery Office, London.
    • Festinger L. (1957) A Theory of Cognitive Dissonance. Stanford University Press, Stanford.
    • Fisher A. (1995) The ethical problems encountered in psychiatric nursing practice with dangerous mentally ill persons. Scholarly Inquiry for Nursing Practice 9(2), 193-208.
    • Harris G., Rice M. & Preston D. (1989) Staff and patient perceptions of the least restrictive alternatives for the short term control of disturbed behaviour. The Journal of Psychiatry and Law 17(2), 239-263.
    • Lebel J. & Goldstein R. (2005) The economic cost of using restraint and the value added by restraint reduction or elimination. Psychiatric Services 56(9), 1109-1114.
    • Lemonidou C., Priami M., Merkouris A., Kalafti M., Tafas C. & Plati C. (2002) Nurses' perceptions toward seclusion and use of restraints for psychiatric patients in Greece. European Journal of Psychiatry 16(2), 81-90.
    • Menckel E. & Viitasara E. (2002) Threats and violence in Swedish care and welfare-magnitude of the problem and impact on municipal personnel. Scandinavian Journal of Caring Sciences. 16(4), 376-385.
    • Moylan L.B. (2009) Construction of an instrument to evaluate nurses' decision making in relation to the use of restraint in acute care psychiatry. Issues in Mental Health Nursing 30(11), 712-717.
    • Moylan L.B. & Cullinan M. (2011) Frequency of assault and severity of injury of psychiatric nurses in relation to the nurses' decision to restrain. Journal of Psychiatric and Mental Health Nursing 18(6), 526-534.
    • Muir-Cochrane E., Bowers L. & Jeffery D. (2009) Comparison in attitudes between nursing and other students in relation to containment measures for disturbed psychiatric patients. Nurse Education Today 29(1), 83-90.
    • Muralidharan S. & Fenton M. (2006) Containment strategies for people with serious mental illness. Cochrane Database of Systematic Reviews. Retrieved from http://onlinelibrary.wiley.com/ doi/10 1002/14651858.CD002084.pub2/full on 30/08/2015.
    • Needham I., Abderhalden C., Dassen T., Haug H.J. & Fische J.E. (2002) Coercive procedures and facilities in Swiss psychiatry. Swiss Medical Weekly 132(19-20), 253-258.
    • Nijman H., Allertz W., Merckelbach H., Campo J. & Ravelli D. (1997) Aggressive behaviour on an acute psychiatric admissions ward. European Journal of Psychiatry 11(2), 106-114.
    • Olofsson B., Jacobsson L., Gilje F. & Norberg A. (1999) Being in conflict: physicians' experience with using coercion in psychiatric care. Nordic Journal of Psychiatry 53(3), 203-210.
    • Parks J. & Carson B. (2008) Sudden death during restraint: do some positions affect lung function? Medical Science and the Law 48(2), 137-141.
    • Paterson B., Bradley P., Stark C., Saddler D., Leadbetter D. & Allen D. (2003) Deaths associated with restraint use in health and social care in the UK. The results of a preliminary survey. Journal of Psychiatric and Mental Health Nursing 10(1), 3-15.
    • Steinert T., Lepping P., Bernhardsgru€tter R., Conca A., Hatling T., Janssen W., Keski-Valkama A., Mayoral F. & Whittington R. (2010) Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends. Social Psychiatry and Psychiatric Epidemiology 45(11), 889-897.
    • Stewart D., Bowers L., Simpson A., Ryan C. & Tziggili M. (2009) Manual restraint of adult psychiatric inpatients: a literature review. Journal of Psychiatric and Mental Health Nursing 16(8), 749-757.
    • Whittington R. & Richter D. (2005) Interactional aspects of violent behaviour on acute psychiatric wards. Psychology, Crime and Law 11, 1-12.
    • Whittington R., Bowers L., Nolan P., Simpson A. & Neil L. (2009) Approval ratings of inpatient coercive interventions in a national sample of mental health service users and staff in England. Psychiatric Services 60(6), 792-798.
    • Wynaden D., Chapman R., McGowan S., Holmes C., Ash P. & Boschman A. (2002) Through the eye of the beholder: to seclude or not to seclude. International Journal of Mental Health Nursing 11(4), 260-268.
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