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Identifying predictors of adverse outcomes after termination of seclusion in psychiatric intensive care units.
Rogers, Jonathan P; Lewis, Gabriella; Lobo, Maria; Wyke, Clementine; Meaburn, Alexander; Harding, Fiona; Garvey, Rebecca; Irvine, Jenny; Yahya, Ahmed Saeed; Kornblum, Daisy; Cullen, Alexis E; Mirfin, David; Lewis, Glyn.
Afiliación
  • Rogers JP; Division of Psychiatry, University College London, UK.
  • Lewis G; South London and Maudsley NHS Foundation Trust, London, UK.
  • Lobo M; South London and Maudsley NHS Foundation Trust, London, UK.
  • Wyke C; South London and Maudsley NHS Foundation Trust, London, UK.
  • Meaburn A; South London and Maudsley NHS Foundation Trust, London, UK.
  • Harding F; South London and Maudsley NHS Foundation Trust, London, UK.
  • Garvey R; South London and Maudsley NHS Foundation Trust, London, UK.
  • Irvine J; South London and Maudsley NHS Foundation Trust, London, UK.
  • Yahya AS; Priory Hospital North London, London, UK.
  • Kornblum D; South London and Maudsley NHS Foundation Trust, London, UK.
  • Cullen AE; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
  • Mirfin D; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
  • Lewis G; South London and Maudsley NHS Foundation Trust, London, UK.
BJPsych Open ; 10(3): e120, 2024 May 22.
Article en En | MEDLINE | ID: mdl-38773812
ABSTRACT

BACKGROUND:

Seclusion is a restrictive practice that many healthcare services are trying to reduce. Previous studies have sought to identify predictors of seclusion initiation, but few have investigated factors associated with adverse outcomes after seclusion termination.

AIMS:

To assess the factors that predict an adverse outcome within 24 h of seclusion termination.

METHOD:

In a cohort study of individuals secluded in psychiatric intensive care units, we investigated factors associated with any of the following

outcomes:

actual violence, attempted violence, or reinitiation of seclusion within 24 h of seclusion termination. Among the seclusion episodes that were initiated between 29 March 2018 and 4 March 2019, we investigated the exposures of medication cooperation, seclusion duration, termination out of working hours, involvement of medical staff in the final seclusion review, lack of insight, and agitation or irritability. In a mixed-effects logistic regression model, associations between each exposure and the outcome were calculated. Odds ratios were calculated unadjusted and adjusted for demographic and clinical variables.

RESULTS:

We identified 254 seclusion episodes from 122 individuals (40 female, 82 male), of which 106 (41.7%) had an adverse outcome within 24 h of seclusion termination. Agitation or irritability was associated with an adverse outcome, odds ratio 1.92 (95% CI 1.03 to 3.56, P = 0.04), but there was no statistically significant association with any of the other exposures, although confidence intervals were broad.

CONCLUSIONS:

Agitation or irritability in the hours preceding termination of seclusion may predict an adverse outcome. The study was not powered to detect other potentially clinically significant factors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: BJPsych Open Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: BJPsych Open Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido