Reflection on the use of seclusion: in an acute mental health facility.
This pilot study provides a snapshot of the use of seclusion within an acute care mental health unit in Queensland, Australia. The study collected baseline data against which practice reform aimed at reducing its use could be gauged. A mixed methodology was adopted, undertaking retrospective chart reviews, collecting qualitative survey data from individual nursing staff (n = 71) and patients (n = 4), and conducting focus groups to identify factors contributing to seclusion use. The study revealed a local facility seclusion rate of 12% compared with a national average of 10%. The re-seclusion rate of 76% was significantly higher than the national average of 31%. Eighty-seven percent of seclusion episodes were longer than 4 hours, compared with a national average of 41%. In approximately one third of cases, the required documentation was incomplete. Consumers mostly perceived seclusion as punishing and nontherapeutic, in contrast to staff, who generally viewed it as appropriate and potentially therapeutic.
Roberts
Damien
D
Princess Alexandra Hospital, Woolloonabba, Queensland 4102, Australia.
Crompton
David
D
Milligan
Eleanor
E
Groves
Aaron
A
D000208:Acute Disease; D001291:Attitude of Health Personnel; D004644:Emotions; D017144:Focus Groups; D006801:Humans; D001523:Mental Disorders / Q000451:nursing*; D010356:Patient Isolation / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010865:Pilot Projects; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data; D011793:Queensland; D012149:Restraint, Physical / Q000009:adverse effects / Q000523:psychology; D012189:Retrospective Studies; D014600:Utilization Review / Q000706:statistics & numerical data