I know that Best Practice says that no restraints or seclusion are to be used. In our hospital, we are currently drafting a new policy on Least Restraint. I would value hearing what other institutions are doing in this area. If you are not using any restraints or seclusion, how do you handle the aggressive, violent and psychotic patient. Please also include whether or not your unit is locked; in a psychiatric institution or in a general hospital.
Many thanks,
Marilyn
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In Manitoba the leaders/managers of Mental Health Services in all of the Regional Health Authorities are collaborating to address this issue. We hope to produce a provincial statement then will create individual policies and protocols to meet the needs of each of the Regions. I will post as info is is available.
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Here in Nova Scotia, we have been working on revisions to our seclusion and restraint policies. On the inpatient units we practice the method of least restraint, but still seclusion has been necessary. I have rarely seen mechanical restraints used on in patients. Now the ER that is a different story. There are not always psych nurses available, nor do all ER's have seclusion rooms. Here mechanical restraints are still being used when necesarry.
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I forgot to add that our acute care units are locked. So is the geriatric units. Rehab and community focused are open units.
ReplyDeleteI work at St. Josephs Healthcare Hamilton, Ontario. I am proud to say that our organization has made the reduction/elimanation of seclusion and restraint a program wide initiative. Our executive team hosted a 2 day workshop a year and a half ago featuring leaders in this change strategy from the US. The workshop was very sucessful in jump starting a culture change within the mental health program. A seclusion and restraint committee was formed and we have begun to role out a number of policy/program changes as a result. We will be looking at the data in weeks and months to come and at least antecdotally feel that we are seeing a postitive impact on the reduction and use of seclusion and restraint. It is worth noting that we are a large divested former Provincial facility with 8 specialty inpatient programs (geriatrics, forensics,moods,and schizophrenia), 4 acute inpatient programs and a psychiatric emergency service. I will keep you posted and look forward to hearing the experience of others.
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