[Recording and reducing coercive measures in psychiatric hospitals].
OBJECTIVE
A project of quality management funded by the German Ministry of Health is presented which aims at recording and reducing of coercive measures (seclusion, restraint, forced medication).


METHODS
Since 1997, a study group for prevention of violence and coercion consisting of physicians, nurses and other psychiatric professionals from 18 psychiatric hospitals is working in Baden-Wuerttemberg and Bayern. A common documentation of coercive measures has been introduced, variables of interest such as percentage of patients exposed to coercive measures in each principal diagnostic group of the ICD-10 have been defined for purposes of benchmarking. Aims of the project are 1) a complete documentation of all coercive measures in 12 psychiatric hospitals in a 12-month period and a benchmarking, taking into account structural characteristics of the hospitals and the respective catchment area, 2) providing a manual for a one-day de-escalation training for all professional groups working with psychiatric patients.


RESULTS
A pilot study demonstrated that about 9 % of all admitted patients have been exposed to coercive measures in a subset of the participating hospitals. The variance between the hospitals was rather high.
Steinert
Tilman
T
Zentrum für Psychiatrie Weissenau, Abt. Psychiatrie I der Universität Ulm. tilman.steinert@zfp-weissenau.de
Baur
Manfred
M
D003068:Coercion; D005858:Germany; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D010356:Patient Isolation / Q000523:psychology; D011619:Psychotropic Drugs / Q000008:administration & dosage; D012149:Restraint, Physical / Q000523:psychology; D017749:Total Quality Management / Q000592:standards*; D014754:Violence / Q000517:prevention & control*
D011619:Psychotropic Drugs