Do we know why we indicate a mechanical restraint?

Abstract

Introduction and objectivesMechanical restraint is a therapeutic procedure commonly applied in acute units in response to psychomotor agitation. Its frequency is between 21 and 59% of patients admitted. These patients represent a risk to both themselves and for health workers. There are not clinical studies that compared if there are differences of the frequency of the specific indication for the mechanical restraint.The aim of this study is to explore the differences of frequency of each indication of mechanical restraint on patients on the psychiatry acute and dual pathology units.Material and methodswe reviewed retrospectively the informatics record of all the mechanical restraints made and the total discharges of the three acute care units and dual disorders of Neuropsychiatry and addictions institute of the Parc de Salut Mar de Barcelona, between January 2012 and January 2015. The episodes of mechanical restraint, the specific indications for them and the DSM-IV diagnostic were coded. Then, was calculated the frequency and proportion of mechanical retrains in the most common diagnostic groups. An ANOV a was performed:– risk of self-aggressiveness;– state of self-aggressiveness;– risk of hetero- aggressiveness;– state of aggressiveness;– risk of psychomotor agitation;– state of psychomotor agitation;– acute confusional state;– fall risk;– risk reduction on therapeutic interventions;– avoid pulling out of life support systems;– facilitate administration of drug treatment;– patient voluntarily requests it;– high-risk of escape.ResultsThe number of discharges analyzed was 4659 from which 838 had an episode of mechanical restraint associated.Disclosure of interestThe authors have not supplied their declaration of competing interest.