Gaskin Cadeyrn J, Elsom Stephen J, Happell Brenda
Centre for Psychiatric Nursing, University of Melbourne, Level 1, 723 Swanston Street, Carlton, Victoria 3053, Australia.
Br J Psychiatry. 2007 Oct;191:298-303. doi: 10.1192/bjp.bp.106.034538.
The authors of a recent systematic review concluded that the use of non-pharmacological containment methods, excluding restraint and seclusion, was not supported by evidence. Their focus on randomised, controlled trials, however, does not reflect the research that has been, or could be, conducted.
To find empirically supported interventions that allow reduction in the use of seclusion in psychiatric facilities.
We reviewed English-language, peer-reviewed literature on interventions that allow reduction in the use of seclusion.
Staff typically used multiple interventions, including state-level support, state policy and regulation changes, leadership, examinations of the practice contexts, staff integration, treatment plan improvement, increased staff to patient ratios, monitoring seclusion episodes, psychiatric emergency response teams, staff education, monitoring of patients, pharmacological interventions, treating patients as active participants in seclusion reduction interventions, changing the therapeutic environment, changing the facility environment, adopting a facility focus, and improving staff safety and welfare.
Reducing seclusion rates is challenging and generally requires staff to implement several interventions.
最近一项系统评价的作者得出结论，除约束和隔离外，非药物控制方法的使用缺乏证据支持。然而，他们对随机对照试验的关注并未反映已开展或可能开展的研究。
寻找经实证支持的干预措施，以减少精神科机构中隔离措施的使用。
我们检索了关于可减少隔离措施使用的干预措施的英文同行评审文献。
工作人员通常采用多种干预措施，包括州级支持、州政策和法规变更、领导作用、实践环境检查、工作人员整合、治疗计划改进、提高工作人员与患者的比例、监测隔离事件、精神科应急反应小组、工作人员教育、患者监测、药物干预、将患者视为减少隔离干预措施的积极参与者、改变治疗环境、改变机构环境、以机构为重点以及改善工作人员的安全和福利。
降低隔离率具有挑战性，通常需要工作人员实施多种干预措施。
