Born to be free: the influence of raising the awareness of the nursing staff to the reduction of the use of physical restraints on restraint orders, hours of restraint and the numbers of patients restrained -- a retrospective study

Dahan, Sagit; Levi, Galit; Behrbalk, Pnina; Melamed, Yuval; Bleich, Avi
January 2007
BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1
Academic Journal
Background Restraint of psychiatric patients is an ethical issue, emphasized by awareness of the rights of mentally ill individuals. Restraint significantly influences the emotional welfare of the patient, is traumatic, deprives the individual of freedom and has aggressive connotations. Aims: To examine the influence of raising the awareness of the staff to reduce use of physical restraints. Hypothesis: Raising the awareness of the staff will lead to a reduction in the number of restraining orders, the duration of restraints and the number of patients restrained. Methods We collected data regarding the number of restraints. Intervention included reduction of restraint policy and tri-monthly meetings to evaluate use of restraints and alternative methods which avoid physical restraints. Data were collected anonymously from four departments where physical restraints are used. Data collection took place twice: following the year of awareness intervention (July 2005 - June 2006), and was compared to the previous year (July 2004 - June 2005), when there was no intervention. Results Significant correlations were found between the groups before and after the intervention. The mean number of restraint orders prior to the intervention was 30.8 (SD = 24.4) and after intervention 22.4 (SD = 1 7.6); p = .03, t = 2.3. There was no significant difference between the departments in the reduction of restraint orders. In the year prior to intervention there was no correlation between occupancy and the number of restraints, and one year post intervention there was a significant correlation between occupancy and the number of restraint orders (p = .001) and occupancy and the number of patients restrained (p = .001). Conclusion Intervention to raise the awareness of the staff to reduce restraints was effective and lead to a reduction in the number of restraints. This is important for creating a professional, supportive, and safe therapeutic environment for the patients.


Related Articles

  • Survey highlights lack of uniformity in C&R training.  // Mental Health Practice;Mar2004, Vol. 7 Issue 6, p5 

    Reports on the survey of mental health care professionals in Great Britain focusing on the use of control and restraint. Lack of uniformity in training of mental health professionals on the use of control and restraint; Need for a randomized control trial.

  • Crash teams feel 'sexual high' in restraint incidents.  // Mental Health Practice;Mar2004, Vol. 7 Issue 6, p5 

    Reports that mental health care professionals need to temper their use of control and restraint in dealing with violent psychiatric patients. Views of London, England-based psychiatric nursing educator Premila Trivedi; Risk of committing abuse.

  • The psychological effects on nursing staff of administering physical restraint in a secure psychiatric hospital: 'When I go home, it's then that I think about it.'. Sequeira, Heather; Halstead, Simon // British Journal of Forensic Practice;Feb2004, Vol. 6 Issue 1, p3 

    The study examines the experiences of physical restraint procedures reported by nursing staff in a secure mental health service. Interview data were subjected to thematic content analysis in accordance with grounded theory methodology. Nursing staff reported a range of emotional responses to the...

  • CONTROL AND RESTRAINT: CHANGING THINKING, PRACTICE AND POLICY.  // Mental Health Practice;Oct2009, Vol. 13 Issue 2, p16 

    The term control and restraint (C&R) has been in common use in mental health practice for the past 20 years. This article explores the appropriateness of its continued use, drawing briefly on frame theory -- a subtype of discourse analysis. The authors conclude that, apart from a brief period in...

  • Illinois finds restraint use can be mitigated.  // Behavioral Health Accreditation & Accountability Alert;Jul2001, Vol. 6 Issue 7, p6 

    Reports on the release of a final report by Equip for Equality Inc. on the use of physical restraint on patients in psychiatric hospitals in Illinois during 1997. Reason of Equip for Equality for conducting the study; Problems found in physical restraint use; Methods used in the study and its...

  • Learning Constraint. Exploring Nurses' Narratives of Psychiatric Work in the Early Years of French Community Psychiatry. Henckes, Nicolas // Culture, Medicine & Psychiatry;Dec2014, Vol. 38 Issue 4, p597 

    This article uses narrative analysis to understand how mental health professionals working in a pilot experiment in community psychiatry in France between 1960 and 1980 made sense of their work experiences. Based on a collection of essays written by these professionals as part of their training...

  • The development of a scale to measure staff attitude to coercion. Husum, Tonje Lossius; Ruud, Torleif // BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1 

    Previous studies have shown that there is considerable variation in the degree to which coercion is used in mental health institutions. This variation between institutions and even between wards is seen in many countries. Many factors have been put foreword to explain this variation in the use...

  • The Ethics of Ambivalence and the Practice of Constraint in US Psychiatry. Brodwin, Paul // Culture, Medicine & Psychiatry;Dec2014, Vol. 38 Issue 4, p527 

    This article investigates the ambivalence of front-line mental health clinicians toward their power to impose treatment against people's will. Ambivalence denotes both inward uncertainty and a collective process that emerges in the midst of everyday work. In their commentaries about ambivalence,...

  • Reducing restraint use in a public psychiatric inpatient service. McCue, Robert E.; Urcuyo, Leonel; Lilu, Yehezkel; Tobias, Teresa; Chambers, Michael J. // Journal of Behavioral Health Services & Research;Apr-Jun2004, Vol. 31 Issue 2, p217 

    The use of behavioral restraint in psychiatric inpatients can have physically and emotionally damaging effects. However, staff may view the use of restraint as a routine and acceptable means of maintaining safety. The goal of this project was to reduce the use of restraint in a public...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics