Beatrice Frajo-Apor1, Immina Macha, Georg Kemmler, Ullrich Meise. 1. Universitätsklinik für Allgemeine und Sozialpsychiatrie, Department für Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck, Anichstraße 46, 6020, Innsbruck, Österreich. beatrice.frajo-apor@i-med.ac.at
Abstract
BACKGROUND: Public opinion on psychiatric medicine is still dominated by images of repression; in particular, the aspects of involuntary admissions, restraint, isolation, or involuntary administration of medication contribute significantly to public prejudice. Furthermore, violations of individual privacy rights and the use of coercion in psychiatry is an ethical challenge. The aim of this study was to describe the "practice of mechanical restraint" at a university hospital in Austria. METHODS: In this study, all admissions to the closed ward at the Department of Psychiatry of the University Clinic of Innsbruck between July and December 2009 were assessed through retrospective data analysis. RESULTS: 529 admissions were identified during the study period. In 148 admitted patients mechanical restraint was arranged at least once. Mechanical restraint was used most frequently and over the longest period of time in patients of the ICD diagnosis group F0. In most cases, "self- harm" had been the reason for restraint. Fourteen percent of the restraints were due to a "danger to others". In patients with "danger to others", a 5 point fixation was used significantly more often than in patients without danger to others, where a restriction by bedrail and/or abdominal belt was most common. CONCLUSIONS: A comparison of these data with those of other centers is limited due to diverse documentation systems. A unified approach in terms of an effective quality management would be desirable in this regard.
BACKGROUND: Public opinion on psychiatric medicine is still dominated by images of repression; in particular, the aspects of involuntary admissions, restraint, isolation, or involuntary administration of medication contribute significantly to public prejudice. Furthermore, violations of individual privacy rights and the use of coercion in psychiatry is an ethical challenge. The aim of this study was to describe the "practice of mechanical restraint" at a university hospital in Austria. METHODS: In this study, all admissions to the closed ward at the Department of Psychiatry of the University Clinic of Innsbruck between July and December 2009 were assessed through retrospective data analysis. RESULTS: 529 admissions were identified during the study period. In 148 admitted patients mechanical restraint was arranged at least once. Mechanical restraint was used most frequently and over the longest period of time in patients of the ICD diagnosis group F0. In most cases, "self- harm" had been the reason for restraint. Fourteen percent of the restraints were due to a "danger to others". In patients with "danger to others", a 5 point fixation was used significantly more often than in patients without danger to others, where a restriction by bedrail and/or abdominal belt was most common. CONCLUSIONS: A comparison of these data with those of other centers is limited due to diverse documentation systems. A unified approach in terms of an effective quality management would be desirable in this regard.
Authors: B Christopher Frueh; Rebecca G Knapp; Karen J Cusack; Anouk L Grubaugh; Julie A Sauvageot; Victoria C Cousins; Eunsil Yim; Cynthia S Robins; Jeannine Monnier; Thomas G Hiers Journal: Psychiatr Serv Date: 2005-09 Impact factor: 3.084