Relationship between the use of seclusion and mechanical restraint and the nurse-bed ratio in psychiatric wards in Japan

International Journal of Law and Psychiatry
Maiko FukasawaYoshio Yamanouchi

Abstract

The relationship between the number of nurses in psychiatric wards and frequency of use of seclusion and restraint has been unclear. We aimed to clarify this relationship in Japanese general psychiatric wards while controlling for patient and ward-level characteristics. We hypothesized that seclusion and mechanical restraint are less likely to be used in a ward with more nurses. We used data for individual admissions from April 2015 to March 2017 in hospitals participating in the Psychiatric Electronic Clinical Observation (PECO) system, which extracted data from each hospital's electronic health record system. We analyzed the data of 10,013 admissions in 113 wards of 23 hospitals. We examined the relationships between the number of nurses per 10 beds in each ward and the use of seclusion and mechanical restraint, controlling for the patients' age, sex, diagnosis, voluntary versus involuntary admission, prescribed dose of antipsychotics, severity of symptoms, and length of stay, in addition to ward-level characteristics including ward size, location (urban or rural), and type of ward (acute ward or not), using multilevel multivariate logistic regression analyses. The fraction of admissions exposed to at least one episode of sec...Continue Reading

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Citations

Dec 3, 2020·Epidemiology and Psychiatric Sciences·G Newton-HowesS Kisely
Jun 5, 2021·Asian Journal of Psychiatry·Kentaro UsudaYoshio Yamanouchi

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