title: A review of interventions to reduce mechanical restraint and seclusion among adult psychiatric inpatients.
abstract: This review examines the nature and effectiveness of interventions to reduce the use of mechanical restraint and seclusion among adult psychiatric inpatients. Thirty-six post-1960 empirical studies were identified. The interventions were diverse, but commonly included new restraint or seclusion policies, staffing changes, staff training, case review procedures, or crisis management initiatives. Most studies reported reduced levels of mechanical restraint and/or seclusion, but the standard of evidence was poor. The research did not address which programme components were most successful. More attention should be paid to understanding how interventions work, particularly from the perspective of nursing staff, an issue that is largely overlooked.
authors.affiliation: City University, London, United Kingdom. duncan.stewart.1@city.ac.uk
authors.forename: Duncan
authors.initials: D
authors.lastname: Stewart
authors.forename: Marie
authors.initials: M
authors.lastname: Van der Merwe
authors.forename: Len
authors.initials: L
authors.lastname: Bowers
authors.forename: Alan
authors.initials: A
authors.lastname: Simpson
authors.forename: Julia
authors.initials: J
authors.lastname: Jones
mesh_terms: D000328:Adult; D003419:Crisis Intervention; D055318:Evidence-Based Nursing; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D007297:Inpatients; D015403:Nursing Evaluation Research / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D016134:Organizational Policy; D010356:Patient Isolation / Q000379:methods; D028701:Patient Rights / Q000331:legislation & jurisprudence; D011568:Psychiatric Nursing / Q000193:education / Q000379:methods*; D012107:Research Design; D012149:Restraint, Physical / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014481:United States