title: Clinical decision making involved in secluding and restraining an adult psychiatric patient: an integrative literature review.
abstract: The purpose of this integrative literature review was to describe different factors involved in the decision-making process of using seclusion or restraint, and to discuss the process in practice. The data used in this review were systematically retrieved from the following databases: CINAHL, Medline and PsycINFO. Manual data retrieval was conducted from the reference lists of the papers that came up in the original database search. A total of 32 studies were selected. Results suggest that the situations that lead to the use of seclusion or restraint are always dynamic and circumstantial. During the decision-making process staff observe a patient's behaviour, assesses risk and chooses and uses interventions that aim to de-escalate the situation. This process is affected by the previous experiences and history of staff as well as the behaviour and previous experience of the patient.
authors.affiliation: Helsinki University Central Hospital, Peijas Hospital Clinic of Psychiatry, Vantaa.
authors.forename: T
authors.initials: T
authors.lastname: Laiho
authors.forename: E
authors.initials: E
authors.lastname: Kattainen
authors.forename: P
authors.initials: P
authors.lastname: Astedt-Kurki
authors.forename: H
authors.initials: H
authors.lastname: Putkonen
authors.forename: N
authors.initials: N
authors.lastname: Lindberg
authors.forename: J
authors.initials: J
authors.lastname: Kylmä
mesh_terms: D000328:Adult; D003657:Decision Making; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010356:Patient Isolation / Q000379:methods*; D011568:Psychiatric Nursing / Q000379:methods*; D012149:Restraint, Physical / Q000379:methods*