The use of restraint in four general hospital emergency departments in Australia

Adam Gerace; Dewi R Pamungkas; Candice Oster; Del Thomson; Eimear Muir-Cochrane

doi:10.1177/1039856214534001

The use of restraint in four general hospital emergency departments in Australia

Australas Psychiatry. 2014 Aug;22(4):366-369. doi: 10.1177/1039856214534001. Epub 2014 May 12.

Authors

Adam Gerace¹, Dewi R Pamungkas², Candice Oster³, Del Thomson⁴, Eimear Muir-Cochrane⁵

Affiliations

¹ Postdoctoral Research Fellow, School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia adam.gerace@flinders.edu.au.
² Master of Nursing by Research Student, School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
³ Research Associate, School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
⁴ Clinical Risk Manager, Quality and Risk, Office of the Chief Psychiatrist and Mental Health Policy, Division of Mental Health & Substance Abuse, SA Department for Health and Ageing, Adelaide, SA, Australia.
⁵ Professor and Chair of Mental Health Nursing, School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.

PMID: 24820291
DOI: 10.1177/1039856214534001

Abstract

Objective: The purpose of this study was to investigate restraint use in Australian emergency departments (EDs).

Method: A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011).

Results: The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained patients had a mental illness diagnosis and were compulsorily hospitalised. Mechanical restraint with the use of soft shackles was the main method used. Restraint was enacted to prevent harm to self and/or others. Median incident duration was 2 hours 5 minutes.

Conclusions: In order to better integrate the needs of mental health clients, consideration is needed as to what improvements to procedures and the ED environment can be made. EDs should particularly focus on reducing restraint duration and the use of hard shackles.

Keywords: emergency department; mechanical restraint; mental health; physical restraint; seclusion.