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Differences in seclusion rates between admission wards: does patient compilation explain?
W A Janssen1, E O Noorthoorn, H L I Nijman
1Board Agency, GGNet Mental Healthcare, Box 2003, NL-7230 GC Warnsveld, The Netherlands. wim.janssen@ggnet.nl
The Psychiatric Quarterly
|May 15, 2012
Summary
Psychiatric hospitals show significant seclusion rate differences. Patient and ward factors explain some, but ward policy and staffing are key to reducing seclusion, especially on smaller units.
Area of Science:
- Psychiatry
- Mental Health Services Research
Background:
- Substantial variations in seclusion rates exist across Dutch psychiatric hospital wards.
- Nurses and managers believe patient characteristics, particularly severe illness, drive these differences.
Purpose of the Study:
- To investigate patient and ward characteristics influencing seclusion rates.
- To test the hypothesis that more severely ill patients correlate with higher seclusion rates.
Main Methods:
- Extreme group analysis of 718 secluded patients and 5,097 admissions across 29 wards in seven hospitals.
- Multivariate and multilevel analyses to explore relationships between patient/ward factors and seclusion hours.
Main Results:
- Patient characteristics significantly correlate with seclusion rates and likelihood of seclusion.
- Ward size also partially explains differences in seclusion hours between wards.
- A significant portion of seclusion rate variation remains unexplained by measured factors.
Conclusions:
- Seclusion rates are influenced by both patient and ward characteristics.
- Ward policy and adequate staffing are critical for reducing seclusion, particularly in smaller psychiatric units.
- Further research is needed to explain the largest portion of inter-ward seclusion differences.
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