title: Reducing restraints: alternatives to restraints on an inpatient psychiatric service--utilizing safe and effective methods to evaluate and treat the violent patient.
abstract: This paper describes the violence safety program instituted at Elmhurst Hospital Center in Queens, New York City in 2001, which significantly reduced the use of restraints and seclusion department wide, while providing a safe and therapeutic environment for patient recovery. The hospital service and program instituted is described, followed by restraint and seclusion data since 1998, and the program's results through 2003. Concurrent data in areas that could be affected by a reduction in restraint and seclusion such as self-injurious behaviors and altercations; use of emergency medication; use of special observation and length of stay data are also presented. In addition, types and frequency of alternative methods utilized to avoid restraints and seclusion are described.
authors.affiliation: Elmhurst Hospital Center/Mt Sinai School of Medicine, Elmhurst, New York 11373, USA. ann.sullivan@mssm.edu
authors.forename: Ann M
authors.initials: AM
authors.lastname: Sullivan
authors.forename: Janet
authors.initials: J
authors.lastname: Bezmen
authors.forename: Charles T
authors.initials: CT
authors.lastname: Barron
authors.forename: James
authors.initials: J
authors.lastname: Rivera
authors.forename: Linda
authors.initials: L
authors.lastname: Curley-Casey
authors.forename: Dominic
authors.initials: D
authors.lastname: Marino
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000534:rehabilitation*; D009519:New York City; D010356:Patient Isolation; D011567:Psychiatric Department, Hospital / Q000592:standards*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D017751:Safety Management / Q000379:methods*; D012637:Security Measures; D016728:Self-Injurious Behavior / Q000517:prevention & control; D014754:Violence / Q000517:prevention & control
chemical_list: D014150:Antipsychotic Agents