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In the U.S. in the late 2010s and into the 2020s (so far), restraint of psychiatric patients and/or people with mental disorders (for all purpose other than very temporarily if another person would be in danger) has come under heavy fire from many professionals (such as those in the Therapist Neurodiversity Collective) and human rights groups (such as Alliance Against Seclusion and Restraint ...
The International Patient Safety Goals (IPSG) were developed in 2006 by the Joint Commission International (JCI). The goals were adapted from the JCAHO's National Patient Safety Goals. [1] Compliance with IPSG has been monitored in JCI-accredited hospitals since January 2006. [1]
Published in February 2012, the guidelines have been described by Dr. Scott L. Zeller, MD, AAEP Past President, as being "more humane, patient-centered interventions." [6] The guidelines rely less upon restraint techniques, and more upon de-escalation techniques that encourage patient buy-in to the management of their agitation. [7]
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Government guidelines state that face down restraint should not be used at all and other types of physical restraint are only for last resort. Research by Agenda found one fifth of women and girl patients in mental health units had suffered physical restraint. Some trusts averaged over twelve face down restraints per female patient.
When using physical restraint, National Institute for Health and Care Excellence suggest supine rather than prone restraint and that physical restraint should ideally not last longer than 10 minutes. [5]: 1.4.24 In Australia, so-called behavioural assessment rooms are provided in emergency rooms where an aggressive patient can be moved to.
A chemical restraint is a form of medical restraint in which a drug is used to restrict the freedom or movement of a patient or in some cases to sedate the patient. Chemical restraint is used in emergency, acute, and psychiatric settings to perform surgery or to reduce agitation, aggression or violent behaviours; [a] it may also be used to control or punish unruly behaviours. [2]
Chemical restraint, such as forcible injection with the antipsychotic haloperidol or benzodiazepine sedative midazolam, may be used to sedate a patient who is agitated. [ 36 ] : 624 [ 37 ] : 152 In some countries, antipsychotics and sedatives can be forcibly administered to those who are committed , using intramuscular depot injection . [ 38 ]