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Risk Factors for Seclusion and Restraint in a Pediatric Psychiatry Day Hospital

Wuroh Timbo1, Aishwarya Sriram2, Elizabeth K Reynolds1

  • 1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA.

Child Psychiatry and Human Development
|December 9, 2015
PubMed

Insights

Seclusion and restraints (SR) are controversial in hospitals. Identifying risk factors like psychiatric issues and trauma history in pediatric day hospitals can reduce SR use and improve patient safety.

Area of Science:

  • Child and Adolescent Psychiatry
  • Healthcare Quality and Safety
  • Trauma-Informed Care

Background:

  • Seclusion and restraints (SR) are debated practices in acute care settings.
  • Limited data exists on SR use within pediatric psychiatric day hospitals.
  • Understanding SR predictors is crucial for improving patient safety.

Purpose of the Study:

  • To identify predictors of seclusion and restraint (SR) use in a pediatric psychiatric day hospital.
  • To analyze demographic and clinical factors associated with SR events.
  • To inform strategies for reducing SR in pediatric mental healthcare.

Main Methods:

  • Retrospective case-control analysis of children admitted to a pediatric psychiatry day hospital over two years.
  • Examined demographic and clinical descriptors in relation to SR events.
  • Utilized univariate and multivariate regression models to identify significant risk factors.

Main Results:

  • Psychiatric morbidity, history of physical abuse, post-traumatic stress disorder, anxiety disorders, and younger age were significant univariate risk factors for SR use.
  • Younger age was identified as a key predictor in this pediatric population.
  • Specific clinical conditions and patient history correlate with increased SR events.

Conclusions:

  • Knowledge of identified risk factors can help prevent the use of seclusion and restraints (SR).
  • Implementing findings can enhance safety within pediatric psychiatric day hospital settings.
  • This research supports a trauma-informed care model by addressing potential triggers for SR.

Keywords:
AbusePediatricRestraintSeclusionTrauma

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