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Published (Version of record)CC BY V4.0, Open Access
Published (Version of record)CC BY V4.0, Open
Journal article
Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before-and-After Study
International journal of mental health nursing, Vol.34(3), pp.1-10
06/2025
PMID: 40346442
Appears in Recent Faculty of Health Publications
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Source: InCites
Abstract
A structured process of reviewing incidents of seclusion and physical restraint supports nurses in managing the emotional and relational impact of restrictive practices. However, these reviews are not a routine feature of everyday acute care provision, and have historically been influenced by practices that reflect a managerial or disciplinary focus. A retrospective before-and-after study was conducted in an adult acute mental health inpatient unit in regional New South Wales, Australia. The goal was to determine the impact of strengths-based restrictive practice review meetings from January 2019 to March 2020, with an equivalent timeframe before its implementation (October 2017-December 2018). The events of seclusion, physical restraint, and Code Blacks (emergency codes requiring security personnel in response to personal safety threats) were compared before and after the implementation of review meetings, with covariate balancing applied to enhance comparability. The reduction in the rate of seclusion was statistically significant post-implementation (incidence rate ratios [IRR] = 0.37, 95% CI [0.24, 0.57], p < 0.001). At the same time, physical restraint showed a statistically insignificant reduction (IRR = 0.76, 95% CI [0.53, 1.09], p = 0.14). Code Black incidents remained stable (IRR = 1.02, 95% CI [0.70, 1.49], p = 0.91). These mixed results indicate that strengths-based reviews play a role in reducing coercion, although additional strategies may be needed to achieve significant reductions in restrictive practice outcomes. Intervention development requires broader service-level changes, with open and robust evaluations that enhance accountability and capture key influencing factors.
Details
- Title
- Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before-and-After Study
- Creators
- Esario Iv Daguman - Southern Cross UniversityAlison Taylor - Coffs Harbour Base Hospital (NSW, Coffs Harbour)Matthew Flowers - Coffs Harbour Base Hospital (NSW, Coffs Harbour)Richard Lakeman - Southern Cross UniversityMarie Hutchinson - Southern Cross University
- Publication Details
- International journal of mental health nursing, Vol.34(3), pp.1-10
- Publisher
- John Wiley and Sons Inc
- Grant note
- Esario IV Daguman is the recipient of a PhD scholarship focused on evaluating an intervention within acute mental health services, co-funded by Southern Cross University and the NSW Office for Health and Medical Research through the Translational Research Grant Scheme.
- Identifiers
- 991013285244702368
- Copyright
- © 2025 The Author(s)
- Academic Unit
- Office of the Vice Chancellor; Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article