Restraint use in acute and extended mental health services for older persons

Adam Gerace, Krista Mosel, Candice Oster, Eimear Muir-Cochrane

    Research output: Contribution to journalArticlepeer-review

    10 Citations (Scopus)

    Abstract

    Restraint of older persons in inpatient and residential care is used to control aggression, and prevent falls and other adverse outcomes. Initiatives to reduce these practices are being implemented worldwide. However, there has been little examination of restraint practice in psychiatric services for older persons. This paper reports a retrospective comparative analysis of restraint use in three acute and two extended care psychiatric inpatient wards in Australia. The analysis involved examination of restraint incidents and comparison of restrained and non-restrained patients. There was significant variation in restraint use between wards. On one acute ward, 12.74% of patients were restrained, although restraint use declined during the data collection period. Patients with dementia were restrained at higher rates than patients with other diagnoses, and restrained patients stayed in hospital for a longer duration. Restraint occurred early in admission, and few differences emerged between those restrained once or multiple times. Mechanical restraint was more prevalent than physical restraint, with restraint predominantly used to manage aggression and falls. Findings provide new data on restraint in older persons' psychiatric services. Greater conceptual understandings of behaviours associated with dementia and the unique needs of patients with these disorders may assist in reducing restraint use in these settings.

    Original languageEnglish
    Pages (from-to)545-557
    Number of pages13
    JournalInternational Journal of Mental Health Nursing
    Volume22
    Issue number6
    DOIs
    Publication statusPublished - Dec 2013

    Keywords

    • Acute care
    • Aged 80 and over
    • Inpatients
    • Psychiatric nursing
    • Residential care
    • Restraint

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