The use of physical restraints and PRN medications in adolescent psychiatric inpatient units

Joohyun Chung PhD, Ming Shao PhD, Riazat Ryan PhD (c), Maureen Eisenstein MSN, Donghui Yan PhD, Vareen Domaleski EdD, Jeungok Choi PhD, Chi Hyun Lee PhD
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引用次数: 1

Abstract

Problem

Although physical restraint practices and psychotropic/sedative pro re neta (PRN, as needed) medications have been commonly used for managing inpatient aggression, little is known about the characteristics of adolescents who receive them in psychiatric adolescent inpatient units. We aimed to determine the relationship between the use of physical restraints and psychotropic/sedative PRN medications, and to characterize individual attributes, substance use, clinical factors, and time of the first restraint episodes of the use of physical restraints and psychotropic/sedative PRN medications.

Methods

A retrospective case-control study approach was used with the data from electronic health records at a pediatric psychiatric hospital in the United States. Descriptive statistics, χ2, multivariate logistic regression, and Cox proportional hazard model were used.

Findings

Participants of younger age and participants with a longer length of stay were significantly associated with the use of physical restraints and psychotropic/sedative PRN medications, although the substance-related risks were not significantly associated with the use of restraints. Physical restraints were more likely to have occurred soon after the admission and tapered off as the length of stay increased.

Conclusions

This study provides important information in understanding the risk factors of the use of restraints and psychotropic/sedative PRN medications in psychiatric adolescent inpatient units.

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青少年精神科住院单位使用物理约束和PRN药物
问题:虽然身体约束和精神/镇静治疗(PRN,视需要)药物通常用于控制住院患者的攻击行为,但人们对在青少年精神病住院病房接受这些治疗的青少年的特征知之甚少。我们的目的是确定使用物理约束和精神药物/镇静PRN药物之间的关系,并描述使用物理约束和精神药物/镇静PRN药物的个体属性、物质使用、临床因素和第一次约束发作的时间。方法采用回顾性病例对照研究方法,收集美国某儿科精神病院电子病历资料。采用描述性统计、χ2、多元logistic回归和Cox比例风险模型。研究发现,年龄较小和住院时间较长的参与者与使用物理约束和精神药物/镇静PRN药物显著相关,尽管物质相关风险与使用约束没有显著相关。身体限制更有可能在入院后不久发生,并随着住院时间的增加而逐渐减少。结论本研究为了解青少年精神科住院病房使用约束和精神药物/镇静药物PRN的危险因素提供了重要信息。
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来源期刊
CiteScore
2.90
自引率
6.70%
发文量
41
期刊介绍: Journal of Child and Adolescent Psychiatric Nursing (JCAPN) is the only nursing journal to focus exclusively on issues of child and adolescent mental health around the world. As a primary resource for nurses and other healthcare professionals in clinical practice, educator roles, and those conducting research in mental health and psychiatric care, the journal includes peer-reviewed, original articles from a wide range of contributors in a broad variety of settings.
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