Impact of the physical environment of psychiatric wards on the use of seclusion

@article{vanderSchaaf2013ImpactOT,
  title={Impact of the physical environment of psychiatric wards on the use of seclusion},
  author={P S van der Schaaf and Elise Dusseldorp and F. M. Keuning and Wim A Janssen and Eric Onno Noorthoorn},
  journal={British Journal of Psychiatry},
  year={2013},
  volume={202},
  pages={142 - 149}
}
Background The physical environment is presumed to have an effect on aggression and also on the use of seclusion on psychiatric wards. Multicentre studies that include a broad variety of design features found on psychiatric wards and that control for patient, staff and general ward characteristics are scarce. Aims To explore the effect of design features on the risk of being secluded, the number of seclusion incidents and the time in seclusion, for patients admitted to locked wards for… 
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A valid and reliable checklist for characterizing seclusion in inpatient psychiatric care is developed and test and may contribute to quality assurance, more reliable statistics and comparisons across sites and periods, improved research on patients' experiences of seclusion, and improvement of psychiatric intensive care.
Efforts to reduce seclusion and restraint use in a state psychiatric hospital: a ten-year perspective.
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The findings suggest that reduction in seclusion and restraint use is sustainable, and judicious use of seclusionand restraint can become the new normative practice-even in the face of potentially disruptive administrative and environmental changes.
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This study supports the hypothesis that the physical environment of a psychiatric intensive care unit has a significant impact on levels of arousal and aggression.
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The aim was to test the predictive and discriminatory characteristics of the East London Modified-Broset, to delineate its decision-making profile for seclusion of adult psychiatric patients, and second to benchmark it against the psychometric properties of the Broset Violence Checklist.
The practice of seclusion: to change or be changed? A review of the current discourse on its use Authors
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The purpose of seclusion in adult mental health settings, its impact on nurses and patients involved in this practice with emphasis on the interpersonal nature of nursing care for this intervention are outlined and opinions are divided amongst professionals, patients and carers.
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The findings are compatible with the hypothesis that more open settings are associated with a more extensive use of coercion, and should be interpreted with caution.
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TLDR
Psychiatric staff on the wards does not share attitudes on aggression, and training for dealing with aggression or violent incidents should be done, at least partly, on an individual level.
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