Newman Julie, Paun Olimpia, Fogg Louis
J Psychosoc Nurs Ment Health Serv. 2018 Jun 1;56(6):23-30. doi: 10.3928/02793695-20180212-02. Epub 2018 Feb 16.
The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes. Seclusion rates were reduced from a 6-month pre-intervention average of 2.95 seclusion hours per 1,000 patient hours to a 6-month post-intervention average of 0.29 seclusion hours per 1,000 patient hours, a 90.2% reduction. Completed staff surveys showed significant staff knowledge gains, non-significant changes in staff attitudes about seclusion, non-significant changes in staff de-escalation skill confidence, and use of the new resource sheet by only 17% of staff. The key study implication is that time-limited, focused staff training interventions can have a measurable impact on reducing inpatient seclusion rates. [Journal of Psychosocial Nursing and Mental Health Services, 56(6), 23-30.].
本文介绍了一项为期90分钟的员工培训干预措施的效果，该措施旨在通过加强员工对隔离替代方案的承诺和提高缓和技能来降低住院精神病患者的隔离率。干预发生在一个拥有18张床位的成人住院精神病科，该科室2015年的隔离率是全国平均水平的7倍。尽管该项目的主要结果是比较干预前后患者的隔离率，但匿名员工调查测量了几个次要结果。隔离率从干预前6个月每1000患者小时2.95个隔离小时的平均水平降至干预后6个月每1000患者小时0.29个隔离小时的平均水平，降低了90.2%。完成的员工调查显示，员工知识有显著增加，员工对隔离的态度没有显著变化，员工缓和技能信心没有显著变化，只有17%的员工使用了新的资源表。该研究的关键启示是，限时、有针对性的员工培训干预措施可以对降低住院患者隔离率产生可衡量的影响。[《心理社会护理与精神卫生服务杂志》，56(6)，23 - 30。]
