Instruments for Measuring Violence on Acute Inpatient Psychiatric Units: Review and Recommendations

AbstractBackgroundRestraint and seclusion were considered a form of treatment but consistently has led to physical and mental injuries to staff and patients. De-escalation has been viewed as a safer option. Understanding which intervention yields decreased injuries, aggression and violence will guide policy and inform practice.ObjectivesTo identify which intervention leads to decreased physical and psychological injury to patients and staff.MethodsThe frequency of physical injuries to patients and staff from aggressive patients; frequency of psychological injuries to patients and staff from violent, aggressive incidents; frequency of violence, agitation and aggression; competence of staff at managing aggression and violence were evaluated.ResultsFourteen studies were included in this review. There are many forms of de-escalation. Studies where techniques were taught to staff, the intervention was effective in decreasing injury in approximately half the studies. De-escalation techniques taught to patients decreased injury in 100% of the studies included in this review.ConclusionConsensus on which intervention works best could not be reached, nor is there overwhelming evidence for a particular type of de-escalation better suited for decreasing aggression and violence. Caution should be exercised when choosing a de-escalation technique for implementation in institutions due to lack of regulating agencies that inform practice and standards. In addition, the literature lacks best practices for de-escalation techniques backed by evidence. Restraint and seclusion should be used as a last resort due to inherent risk associated with the intervention.

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The usage of coercive measures in psychiatric units and its potential counter-therapeutic impact on outcome

Evidence-Based Nursing ◽

10.1136/ebnurs-2019-103125 ◽

2019 ◽

Vol 23 (2) ◽

pp. 53-53 ◽

Cited By ~ 1

Author(s):

Akhtar Ebrahimi Ghassemi

Keyword(s):

Coercive Measures ◽

Therapeutic Impact ◽

Psychiatric Units

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The Use of Complementary and Alternative Medicine (CAM) in Psychiatric Units in Sweden

Issues in Mental Health Nursing ◽

10.1080/01612840.2020.1744203 ◽

2020 ◽

Vol 41 (10) ◽

pp. 946-957

Author(s):

Maria Wemrell ◽

Anna Olsson ◽

Kajsa Landgren

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Psychiatric Units ◽

Complementary And Alternative

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Revolving door syndrome: A new meaning for an old concept?

European Psychiatry ◽

10.1016/s0924-9338(11)72819-x ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1114-1114

Author(s):

P. Garrido ◽

C. Saraiva

Keyword(s):

Health Care ◽

Hospital Admissions ◽

Strong Predictor ◽

Statistical Significance ◽

Revolving Door ◽

Full Time ◽

University Hospitals ◽

Short Term ◽

Care Services ◽

Psychiatric Units

Introduction“Revolving Door Syndrome” is usually defined as a cyclical pattern of short-term readmissions to the psychiatric units of health care centers, by young adults with chronic psychiatric disorders. Concerning the actual politics in health care sistems, with sucessive budget cuts and reduction of full-time hospital beds, the authors' aim has been to identify the patients that enter into a vicious circle of being admitted to hospital, discharged, and admitted again, as well as the underlying psychosocial reasons.ObjectivesThe purpose of this study was to identify factors associated with short-term readmissions to psychiatric acute care services, with statistical significance, and clinical interest, within a portuguese sample.Material and methodsRetrospective cohort study, in which the medical records of patients admitted to Coimbra University Hospitals two or more times (with short-term readmissions) between January and December of 2009, were analysed for socio-demographic characteristics, psychiatric diagnostic, presence of comorbidities, number of hospital admissions within that year, psychofarmacological treatments and presence of social and familiar support.Results and conclusionsThe authors found that lack of social and familiar support is a strong predictor for “Revolving Door Syndrome”, as well as the presence of a chronic psychiatric disorder.

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Peripheral recovery: ‘Keeping safe’ and ‘keep progressing’ as contradictory modes of ordering in a forensic psychiatric unit

Environment and Planning D Society and Space ◽

10.1177/02637758211013032 ◽

2021 ◽

pp. 026377582110130

Author(s):

Laura McGrath ◽

Steven D Brown ◽

Ava Kanyeredzi ◽

Paula Reavey ◽

Ian Tucker

Keyword(s):

Psychiatric Unit ◽

Therapeutic Landscape ◽

Criminal Justice Systems ◽

Psychiatric Units ◽

Carceral Geography ◽

Forensic Psychiatric ◽

The Uk ◽

Institutional Space ◽

Photo Production ◽

Modes Of Ordering

Sitting between the psychiatric and criminal justice systems, and yet fully located in neither, forensic psychiatric units are complex spaces. Both a therapeutic landscape and a carceral space, forensic services must try to balance the demands of therapy and security, or recovery and risk, within the confines of a strictly controlled institutional space. This article draws on qualitative material collected in a large forensic psychiatric unit in the UK, comprising 20 staff interviews and 20 photo production interviews with patients. We use John Law’s ‘modes of ordering’ to explore how the materials, relations and spaces are mobilised in everyday processes of living and working on the unit. We identify two ‘modes of ordering’: ‘keeping safe’, which we argue tends towards empty, stultified and static spaces; and ‘keep progressing’ which instead requires filling, enriching and ingraining spaces. We discuss ways in which tensions between these modes of ordering are resolved in the unit, noting a spatial hierarchy which prioritises ‘keeping safe’, thus limiting the institutional capacity for engendering progress and change. The empirical material is discussed in relation to the institutional and carceral geography literatures with a particular focus on mobilities.

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Society of Neuropathologists and Psychiatrists at Kazan University

Kazan medical journal ◽

10.17816/kazmj78231 ◽

1927 ◽

Vol 23 (3) ◽

pp. 370-371

Keyword(s):

The World ◽

Psychiatric Units

Prof. T. I. Yudin delivered a speech entitled "In Memory of Kerelin," in which he characterized K. as a genius of psychiatry, who created the basic psychiatric units, constituted an epoch in psychiatry, and had a tremendous influence on all psychiatrists of the world.

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MEDICATION SYSTEM: ANALYSIS OF ACTIONS TAKEN BY PROFESSIONALS IN PSYCHIATRIC UNITS

Texto & Contexto - Enfermagem ◽

10.1590/0104-07072016000170015 ◽

2016 ◽

Vol 25 (4) ◽

Cited By ~ 1

Author(s):

Maristela Monteschi Souta ◽

Paulo Celso Prado Telles Filho ◽

Kelly Graziani Giacchero Vedana ◽

Luiz Jorge Pedrão ◽

Adriana Inocenti Miasso

Keyword(s):

Medical Records ◽

System Analysis ◽

Psychiatric Hospitalization ◽

Survey Study ◽

Electronic Prescription ◽

Cross Sectional ◽

Exploratory Survey ◽

Psychiatric Units ◽

Pharmacy Data ◽

Electronic Prescriptions

ABSTRACT This study analyzed the medication systems in psychiatric units of a general hospital and a psychiatric hospital in the state of São Paulo, Brazil. It is a quantitative and cross-sectional, exploratory survey study with 144 professionals from the areas of medication, nursing and pharmacy. Data were collected by direct, non-participative observation and by medical records review. Data were analyzed using descriptive statistics. Factors that affect patient safety, such as interruptions during prescription, handwritten changes to electronic prescriptions, limited handling of the electronic prescription system, unavailable clinical pharmacy, mistakes in activities related to the preparation and administration of medications and other factors were identified. The study reveals the susceptible points for the occurrence of medication errors in psychiatric hospitalization departments and discusses recommendations and technological resources that can promote security in the medication system.

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