OBJECTIVES: State psychiatric hospitals across the U.S. were surveyed to
develop national normative data on the incidence of seclusion and restrain
and of injuries to patients and staff resulting from aggression by
patients. METHODS: A survey instrument was sent to 225 state hospitals
requesting information for a one-year period on the number of patients
placed in seclusion or restraint, the number of discrete incidents of
seclusion and restraint, the number of hours patients spent in seclusion or
restraint, and the number of injuries to patients and staff attributable to
aggression by patients. Rates of seclusion, restraint, and injuries were
calculated to control for variation in hospital censuses. Percentile ranks
for the various rates were calculated to allow hospitals to compare their
rates. RESULTS AND CONCLUSIONS: A total of 101 state hospitals in 44 states
and the District of Columbia returned the survey. In general, smaller
hospitals had higher rates of seclusion and restraint. However, large
standard deviations in the mean rates suggested considerable variability
between hospitals in the sample. Small positive correlations between rates
of seclusion and rates of restraint suggested that the hospitals did not
use of the two interventions exclusively.
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