OBJECTIVE: To reduce the use of restraint and seclusion with children and adolescents in psychiatric inpatient units by promoting a preventive, strength-based model of care. METHOD: The State Mental Health Authority used data analysis, quality improvement strategies, regulatory oversight, and technical assistance to develop and implement system change over a 22-month period. No changes in regulation or policy were undertaken. RESULTS: Comparative data collected before and after the interventions demonstrated substantial reductions in the use of restraint and seclusion. Child units (age 5-12) decreased from 84.03 to 22.78 episodes per 1,000 patient days (72.9%), adolescent units from 72.22 to 37.99 episodes (47.4%), and mixed child/adolescent units from 73.37 to 30.08 episodes (59%). CONCLUSIONS: The use of restraint and seclusion in child and adolescent inpatient settings can be reduced through a systems approach, which may have applicability to other settings and systems.
OBJECTIVE: To reduce the use of restraint and seclusion with children and adolescents in psychiatric inpatient units by promoting a preventive, strength-based model of care. METHOD: The State Mental Health Authority used data analysis, quality improvement strategies, regulatory oversight, and technical assistance to develop and implement system change over a 22-month period. No changes in regulation or policy were undertaken. RESULTS: Comparative data collected before and after the interventions demonstrated substantial reductions in the use of restraint and seclusion. Child units (age 5-12) decreased from 84.03 to 22.78 episodes per 1,000 patient days (72.9%), adolescent units from 72.22 to 37.99 episodes (47.4%), and mixed child/adolescent units from 73.37 to 30.08 episodes (59%). CONCLUSIONS: The use of restraint and seclusion in child and adolescent inpatient settings can be reduced through a systems approach, which may have applicability to other settings and systems.
Authors: Martha Okafor; Glenda Wrenn; Victor Ede; Nana Wilson; William Custer; Emile Risby; Michael Claeys; Frank E Shelp; Hany Atallah; Gail Mattox; David Satcher Journal: Community Ment Health J Date: 2015-12-28
Authors: Wuroh Timbo; Aishwarya Sriram; Elizabeth K Reynolds; Renee DeBoard-Lucas; Matthew Specht; Carolyn Howell; Colleen McSweeney; Marco A Grados Journal: Child Psychiatry Hum Dev Date: 2016-10
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