Use of restrictive interventions in a child and adolescent inpatient unit: predictors of use and effect on patient outcomes

Duke, Suzanne G., Scott, James and Dean, Angela J. (2014) Use of restrictive interventions in a child and adolescent inpatient unit: predictors of use and effect on patient outcomes. Australasian Psychiatry, 22 4: 360-365. doi:10.1177/1039856214532298


Author Duke, Suzanne G.
Scott, James
Dean, Angela J.
Title Use of restrictive interventions in a child and adolescent inpatient unit: predictors of use and effect on patient outcomes
Journal name Australasian Psychiatry   Check publisher's open access policy
ISSN 1039-8562
1440-1665
Publication date 2014-08-01
Year available 2014
Sub-type Article (original research)
DOI 10.1177/1039856214532298
Volume 22
Issue 4
Start page 360
End page 365
Total pages 6
Place of publication London, United Kingdom
Publisher Sage
Collection year 2015
Language eng
Formatted abstract
Objectives: Restrictive interventions (seclusion, physical restraint, and use of acute/p.r.n. sedation) may have negative effects on patients. Identifying factors associated with use of restrictive interventions and examining their effect on admission outcomes is important for optimising inpatient psychiatric care.

Methods:
This study documented use of restrictive interventions within a child and adolescent psychiatric inpatient unit for 15 months. Two models examined predictors of use of restrictive interventions: (i) incident characteristics; and (ii) patient characteristics. The relationship between use of restrictive interventions and global clinical outcomes was also examined.

Results:
Of 134 patients admitted during the study period (61.9% female, mean age=13.8±2.9 years), 26.9% received at least one restrictive intervention. Incident factors associated with restrictive interventions were: physical aggression, early admission stage, and occurrence in private space. Patient factors that predicted use of restrictive interventions were developmental disorder and younger age. Use of restrictive interventions was not associated with increased length of stay or diminished improvement in global symptom ratings.

Conclusions:
Further research is needed to identify best practice in children at high risk for receiving restrictive interventions.
Keyword Seclusion
Restraint
Aggression
Developmental disorders
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2015 Collection
School of Medicine Publications
 
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Created: Fri, 18 Jul 2014, 00:37:17 EST by James Scott on behalf of Psychiatry - Royal Brisbane and Women's Hospital