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Posted: January 30th, 2024
Best Practices for Restraint Use and Seclusion in Psychiatric Centers
The use of restraint and seclusion (R/S) in psychiatric centers has been a longstanding practice to manage dangerous behavior and maintain patient safety. However, there have been significant efforts to reduce their use, with a shift in attitude and practice regarding their use. Here are some best practices and guidelines:
Least Restrictive Intervention: When necessary, the least restrictive intervention should be chosen. This involves early intervention with less restrictive measures, such as verbal and non-verbal communication, reduced stimulation, active listening, and diversionary techniques
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Preventative Interventions: The key to reducing the use of seclusion and restraint is the prevention of aggression. This includes assessing the patient and intervening early with less restrictive measures, as well as changing aspects of the unit to promote a culture of structure, calmness, engagement, negotiation, and collaboration
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Patient Involvement: Patients should be included as much as possible in the decision-making process regarding the use of restraint and seclusion. Involving patients in safety procedures can increase their safety
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Continuous Training and Evaluation: Healthcare providers must be continuously trained, and staff should review restraint and seclusion situations to evaluate performance and ensure safe medical practice
In conclusion, the best practices for restraint use and seclusion in psychiatric centers emphasize the importance of using these interventions as a last resort, early intervention with less restrictive measures, patient involvement, and continuous training and evaluation of staff.
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What are the potential long-term effects of restraint and seclusion on patients
The potential long-term effects of restraint and seclusion on patients are a subject of concern and ongoing research. A systematic review of studies on this topic identified both negative and beneficial effects of seclusion and restraint, with some patients reporting feelings of safety and security, while others experienced negative effects such as increased length of stay and adverse outcomes
. Additionally, the use of seclusion and restraint is associated with the loss of dignity, respect, and demoralization for many patients
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Guidelines emphasize that when seclusion or restraint is necessary, the least restrictive intervention should be chosen, and patients' preferences should be taken into account. It is also recommended to prevent aggression through early intervention with less restrictive measures and to involve patients in the decision-making process regarding the use of these interventions
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Furthermore, there has been a shift in attitude and practice regarding the use of seclusion and restraint in mental health and addictions treatment settings. These practices are now being viewed as a crisis intervention technique to be used only as a last resort when less restrictive measures have failed, and they are no longer perceived as therapeutic for patients
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In conclusion, the potential long-term effects of restraint and seclusion on patients are complex, with some experiencing feelings of safety and security, while others suffer from negative outcomes such as increased length of stay and adverse effects. It is essential to carefully consider the use of these interventions, prioritize the least restrictive measures, and involve patients in the decision-making process.
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