Analysis of the Use of Mechanical Restraints and the Restraining Periods Applied in Acute Psychiatric Clinics in a One-Year Period

Abstract

Objectives: This study was performed to analyze the use of mechanical restraints and the restraining periods applied in acute psychiatric clinics in a one-year period. Methods: This study, which was comparative, cross-sectional and descriptive, was performed in acute psychotic clinics of a psychiatric hospital in Istanbul, which has three female wards, six male wards and a 411 total bed capacity. The restraint records of the psychotic clinics over the period November 2007 to January 2008 were analyzed, and the findings were communicated to the hospital management and clinic teams and compared with the records of the same period the following year. The results were analyzed in a computer environment using percentage, chi-square and T tests. Results: The highest number of restrained female patients in the acute psychiatric clinics was 194, whereas the same number for male patients was 112, and the restraining period for female patients was also found to be longer than that of male patients. When the first year records were compared to the following year's records, it was seen that the total number of restrained cases dropped from 1,014 to 750 and the average range of the restraining period fell from 217.3 +/- 203.6 minutes to 142.3 +/- 143.7 minutes. Conclusion: Both the use of restraint and the restraining periods in the acute psychiatric clinics were found to be high, and the figures were observed to decrease the following year. It can be expected that the feedback given to the hospital management and clinic teams was effective, but the factors affecting such a decrease should be analyzed. In conclusion, studies towards aggression management should be intensified. Moreover, the patients' environment should be organized in a therapeutic milieu and decreased utilization of restraint and shortened restraining periods should be considered.