East London Foundation NHS Trust, Queen Mary University, London, UK.
J Psychiatr Ment Health Nurs. 2012 Nov;19(9):799-806. doi: 10.1111/j.1365-2850.2011.01856.x. Epub 2012 Feb 1.
In most inpatient psychiatric care systems it is permissible in certain situations for staff to forcibly inject patients with psychotropic medication. The aim of this study is to describe what precedes and follows a coerced intramuscular injection within a nursing shift. Data were collected on the sequence of conflict (aggression, absconding, etc.) and containment (seclusion, restraint, etc.) for the first 2 weeks of 522 acute admissions on 84 wards in 31 UK hospitals. Injections were given to 9% of patients. Aggression, regular medication refusal and pro re nata (PRN) medication refusal preceded injections. The giving of coerced medication concluded most crises. Coerced medication effectively resolves crises in the short term. Staff should offer oral PRN as an alternative, unless this is unsafe. Where only verbal violence has occurred staff should try to resolve the crisis without enforcing medication. More research on the best way to respond to inpatients' medication refusal is required.
在大多数住院精神病护理系统中，在某些情况下，工作人员可以强制给患者注射精神药物。本研究的目的是描述在一个护理班次内，强制肌肉注射之前和之后的情况。在 31 家英国医院的 84 个病房中，对 522 名急性入院患者的前两周的冲突（攻击、潜逃等）和遏制（隔离、约束等）的顺序进行了数据收集。9%的患者接受了注射。注射前发生了攻击行为、常规药物拒绝和按需药物拒绝。强制用药结束了大多数危机。强制用药在短期内有效地解决了危机。除非不安全，否则工作人员应提供口服按需药物作为替代。如果只有口头暴力发生，工作人员应尝试在不强制用药的情况下解决危机。需要更多关于如何应对住院患者药物拒绝的最佳方法的研究。
