Reynolds Elizabeth K, Grados Marco A, Praglowski Nancy, Hankinson Jessica C, Deboard-Lucas Renee, Goldstein Laura, Perry-Parrish Carisa K, Specht Matthew W, Ostrander Rick
The authors are with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore (e-mail:
Psychiatr Serv. 2016 May 1;67(5):570-3. doi: 10.1176/appi.ps.201500039. Epub 2016 Feb 14.
Despite a call for the reduction and ultimate elimination of the use of seclusion and restraint, research on reduction of these practices in behavioral programs has been limited. This study sought to examine the effectiveness of a modified version of the Positive Behavioral Interventions and Supports (M-PBIS) implemented in a youth psychiatric inpatient unit to reduce use of seclusion and restraint.
This naturalistic, prospective study covered a four-year period (1,485 admissions).
The number of seclusion and restraint events, mean duration of events, and percentage of patients placed in seclusion or restraint were reduced, as was the overall seclusion rate for the unit. Furthermore, there was a significant reduction in the use of pro re nata (PRN) medications for agitation.
These findings suggest that M-PBIS is a promising intervention to use in youth psychiatric inpatient units to reduce seclusion and restraint and PRNs.
尽管呼吁减少并最终消除隔离和约束措施的使用，但针对行为项目中减少这些措施的研究一直有限。本研究旨在检验在青少年精神科住院单元实施的改良版积极行为干预与支持（M-PBIS）在减少隔离和约束使用方面的有效性。
这项自然主义的前瞻性研究为期四年（1485例入院患者）。
隔离和约束事件的数量、事件的平均持续时间、接受隔离或约束的患者百分比均有所降低，该单元的总体隔离率也有所下降。此外，用于躁动的按需（PRN）药物的使用显著减少。
这些发现表明，M-PBIS是一种有前景的干预措施，可用于青少年精神科住院单元以减少隔离、约束及按需药物治疗。
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