Journal Article10.1002/(SICI)1098-240X(199906)22:3<189::AID-NUR2>3.0.CO;2-Q
Nurses' judgments regarding seclusion and restraint of psychiatric patients: a social judgment analysis.
R J Holzworth,Celia E. Wills +1 more
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TL;DR: Clinical judgment of psychiatric nurses was investigated using judgment analysis within the framework of social judgment theory, and nurses generally favored close observation of patients over seclusion and restraint, and information about current behavior and functioning had more impact on nurses' judgments than did patient history.
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Abstract: Clinical judgment of psychiatric nurses was investigated using judgment analysis within the framework of social judgment theory. Nine nurses at a short-term psychiatric care facility made recommendations concerning restraint and seclusion for 80 patients described on paper in terms of 17 characteristics (cues). Nurses generally favored close observation of patients over seclusion and restraint, and information about current behavior and functioning had more impact on nurses' judgments than did patient history. Nurses had good insight into the nature of their own judgments. However, individual differences in cue utilization and inconsistency in strategy usage led to disagreement among nurses about specific recommendations for particular patients. No one patient received identical recommendations from all nurses, and nurses agreed with each other on specific recommendations only about a third of the time. The lack of agreement has implications for development of staff training programs and further research on the clinical judgment processes of nurses.
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Citations
Reducing Seclusion and Restraint Use in Mental Health Settings: Core Strategies for Prevention
TL;DR: Organizations that wish to reduce S/R use need to embrace a prevention approach, follow the tenets of continuous quality improvement, and develop a reduction plan individualized for that facility.
250
A practitioner's guide to persuasion: an overview of 15 selected persuasion theories, models and frameworks.
TL;DR: Understanding key constructs and general formulations of persuasive theories may allow practitioners to employ useful theoretical frameworks when interacting with patients, and may lead to the development of novel communication approaches with existing patients.
151
A systematic review of the safety and effectiveness of restraint and seclusion as interventions for the short-term management of violence in adult psychiatric inpatient settings and emergency departments.
Louise Nelstrop,Jackie Chandler-Oatts,William Bingley,Tony Bleetman,Frank Corr,Jane Cronin-Davis,Donna-Maria Fraher,Phil Hardy,Sophie Jones,Kevin Gournay,Sue Johnston,Stephen P. Pereira,Peter Pratt,Rick Tucker,Aki Tsuchiya +14 more
TL;DR: Insufficient evidence is available to determine whether seclusion and restraint are safe and/ or effective interventions for the short-term management of disturbed/violent behaviour in adult psychiatric inpatient settings, and these interventions should be used with caution and only as a last resort once other methods of calming a situation and/or service user have failed.
144
International variation in containment measures for disturbed psychiatric inpatients: A comparative questionnaire survey
Len Bowers,Bert van der Werf,Aila Vokkolainen,Eimear Muir-Cochrane,Teresa Allan,Jane Alexander +5 more
TL;DR: Future evaluation research on containment measures should use time taken to calm the patient, injury to patients and others, as primary outcomes, and national clinical audit and injury reporting systems would enable the identification of methods that are truly physically injurious to patients, aiding in the rational selection of appropriate containment measures.
134
Re-Designing State Mental Health Policy to Prevent the Use of Seclusion and Restraint
TL;DR: The members of the National Association of State Mental Health Program Directors (NASMHPD) believe that seclusion and restraint, including “chemical restraints," are safety interventions of last resort and are not treatment interventions.
125
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Staffing levels and seclusion use.
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TL;DR: The findings suggest that staffing levels play a crucial role in the practice of seclusion, however, the overall staffing level must be considered along with other factors in the makeup of the staff group, including the ratio of female to male staff and the experience level of those staff.
45
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TL;DR: The findings supported attribution theory and research in that most patients and nurses gave causes for the patients' restraint, but the data suggest more research is needed in this area.
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•Journal Article
A descriptive study of seclusion: the unit environment, patient behavior, and nursing interventions.
TL;DR: Variables studied did not indicate that units were more disturbed when seclusions were initiated than at other times, and patient behavior and nursing interventions throughout seclusion was generally used in conjunction with other interventions.
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