Abstract
Seclusion and restraint continue to be used across psychiatric inpatient and
emergency settings, despite calls for elimination and demonstrated efficacy of reduction initiatives.
This study investigated nurses’ perceptions regarding reducing and eliminating the use of these
containment methods with psychiatric consumers. Nurses (n = 512) across Australia completed an
online survey examining their views on the possibility of elimination of seclusion, physical
restraint, and mechanical restraint as well as perceptions of these practices and factors influencing
their use. Nurses reported working in units where physical restraint, seclusion, and, to a lesser
extent, mechanical restraint were used. These were viewed as necessary last resort methods to
maintain staff and consumer safety, and nurses tended to disagree that containment methods
could be eliminated from practice. Seclusion was considered significantly more favourably than
mechanical restraint with the elimination of mechanical restraint seen as more of a possibility
than seclusion or physical restraint. Respondents accepted that use of these methods was
deleterious to relationships with consumers. They also felt that containment use was a function of
a lack of resources. Factors perceived to reduce the likelihood of seclusion/restraint included
empathy and rapport between staff and consumers and utilizing trauma-informed care principles.
Nurses were faced with threatening situations and felt only moderately safe at work, but believed
they were able to use their clinical skills to maintain safety. The study suggests that initiatives at
multiple levels are needed to help nurses to maintain safety and move towards realizing directives
to reduce and, where possible, eliminate restraint use.
Original language | English |
---|---|
Pages (from-to) | 209-225 |
Number of pages | 17 |
Journal | International Journal of Mental Health Nursing |
Volume | 28 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Feb 2019 |
Bibliographical note
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Keywords
- acute inpatient units
- emergency departments
- mechanical restraint
- physical restraint
- psychiatric consumers
- seclusion