<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Diane E. Allen</style></author><author><style face="normal" font="default" size="100%">Susan J. Fetzer</style></author><author><style face="normal" font="default" size="100%">Kathleen S. Cummings</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Decreasing Duration of Mechanical Restraint Episodes by Increasing Registered Nurse Assessment and Surveillance in an Acute Psychiatric Hospital</style></title><secondary-title><style face="normal" font="default" size="100%">Journal of the American Psychiatric Nurses Association</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">aggression</style></keyword><keyword><style  face="normal" font="default" size="100%">emergency psychiatric nursing</style></keyword><keyword><style  face="normal" font="default" size="100%">engagement</style></keyword><keyword><style  face="normal" font="default" size="100%">seclusion and restraint</style></keyword><keyword><style  face="normal" font="default" size="100%">standards of practice</style></keyword><keyword><style  face="normal" font="default" size="100%">violence</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2020</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://journals.sagepub.com/doi/10.1177/1078390319878776</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">26</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;INTRODUCTION:&amp;nbsp;The application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care to assure patient safety and expedite release at the earliest opportunity. While current Centers for Medicare &amp;amp; Medicaid Services regulations require trained staff to continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. The experience of an acute psychiatric hospital demonstrates that more frequent registered nurse assessments can decrease duration of mechanical restraint episodes.&amp;nbsp;AIMS:&amp;nbsp;The aim of this three-part quality improvement project was to decrease duration of mechanical restraint episodes by increasing the frequency of registered nurse assessment and surveillance.&amp;nbsp;METHODS:&amp;nbsp;First, the requirement for frequency of face-to-face registered nurse assessment during episodes of mechanical restraint was increased from once every hour to once every 30 minutes. Second, the frequency of assessment was increased on half the hospital&amp;rsquo;s units, from every 30 minutes to continuous registered nurse presence during restraint. Finally, the remaining units adopted 1:1 registered nurses during restraint. Mean hours of restraint per episode were measured and compared before and after each practice change.&amp;nbsp;RESULTS:&amp;nbsp;Mean duration of restraint episodes decreased 23% in the first change cycle, 12% in the second, and 44% in the third. Overall, there was a statistically significant 30% decrease in mean duration of restraint episodes.&amp;nbsp;CONCLUSIONS:&amp;nbsp;Increased frequency of registered nurse assessment and surveillance can significantly decrease duration of mechanical restraint episodes. Nurses are encouraged to adopt mechanical restraint practice standards that provide continuous psychiatric intensive care by a registered nurse.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">3</style></issue><section><style face="normal" font="default" size="100%">245-249</style></section></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Patricia S. Mann-Poll</style></author><author><style face="normal" font="default" size="100%">Eric O. Noorthoorn</style></author><author><style face="normal" font="default" size="100%">Annet Smit</style></author><author><style face="normal" font="default" size="100%">Giel J. M. Hutschemaekers</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Three Pathways of Seclusion Reduction Programs to Sustainability: Ten Years Follow Up in Psychiatry</style></title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Inpatient psychiatry</style></keyword><keyword><style  face="normal" font="default" size="100%">Program evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">seclusion and restraint</style></keyword><keyword><style  face="normal" font="default" size="100%">Sustainability</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2020</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://link.springer.com/article/10.1007/s11126-020-09738-1#article-info</style></url></web-urls></urls><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;From 2004 onwards, above 50 seclusion reduction programs (SRP) were developed, implemented and evaluated in the Netherlands. However, little is known about their sustainability, as to which extent obtained reduction could be maintained. This study monitored three programs over ten years seeking to identify important factors contributing to this. We reviewed documents of three SRPs that received governmental funding to reduce seclusion. Next, we interviewed key figures from each institute, to investigate the SRP documents and their implementation in practice. We monitored the number of seclusion events and the number of seclusion days with the Argus rating scale over ten years in three separate phases: 2008&amp;ndash;2010, 2011&amp;ndash;2014 and 2015&amp;ndash;2017. As we were interested in sustainability after the governmental funding ended in 2012, our focus was on the last phase. Although in different rate, all mental health institutes showed some decline in seclusion events during and immediately after the SRP. After end of funding one institute showed numbers going up and down. The second showed an increase in number of seclusion days. The third institute displayed a sustained and continuous reduction in use of seclusion, even several years after the received funding. This institute was the only one with an ongoing institutional SRP after the governmental funding. To sustain accomplished seclusion reduction, a continuous effort is needed for institutional awareness of the use of seclusion, even after successful implementation of SRPs. If not, successful SRPs implemented in psychiatry will easily relapse in traditional use of seclusion.&lt;/p&gt;</style></abstract></record></records></xml>