title: The effects of a changing culture on a child and adolescent psychiatric inpatient unit.
abstract: OBJECTIVE
  To examine the impact of restructuring a child and adolescent psychiatry inpatient unit on reportable incidents (including verbal or physical aggression), seclusion, security, constant observation, sick leave and lengths of stay.
  
  
  METHODS
  Data was collected regarding a seven-bed child and adolescent psychiatric unit between 2008 and 2010, comparing data from 2008 and 2009 (before) to 2010 (after).
  
  
  RESULTS
  Occurrences, sick leave, security, seclusion and constant observation all decreased in 2010 compared to 2008 and 2009, although only the decrease in constant observation was statistically significant. Length of stay was not affected.
  
  
  CONCLUSIONS
  A broad representation of multidisciplinary team members, increased consistency and improved communication may be associated with reductions in reportable incidents, seclusion, security and constant observation.
authors: Discipline of Psychiatry, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland.
authors: Weldon
authors: W
authors: Bonnell
authors: Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario.
authors: Yuri A
authors: YA
authors: Alatishe
authors: Discipline of Psychiatry, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland.
authors: Anna
authors: A
authors: Hofner
keywords: collaborative problem solving; patient admission; patient care team; psychiatric department; youth