engleski

Use of coercive measures in psychiatry - the experience of nurses and technicians

Background: The use of coercive measures is the result of a variety of factors that include understanding aggressive behaviour, educating staff to perform de-escalation and risk assessment, the number of staff, organization of treatment, and staff's attitudes. In order for medical staff to apply an individual approach to each person who demonstrates aggressive behaviour, it is necessary to analyze all the factors that influence the use of coercive measures. The aim of this study was to investigate how coercive measures are applied in psychiatric institutions in the Republic of Croatia so that guidelines for reducing coercive measures could be suggested. Subjects and methods: A multicenter study was conducted during February and March 2016 at 16 Croatian Psychiatric Clinics, Hospitals and Departments. In the study were involved 238 subjects. A questionnaire was created for the purpose of the survey and was contained five units: sociodemographic data, work organization and department structure, education, use of coercive measures, and documentation. Results: The results indicate weaknesses related to the number and education of staff, space planning and indications for the use of coercive measures, which can result in violations of the rights of persons with mental disorders and increased risk of injury to both patients and staff. Significant results show that more than 58% of examinee were injured in the use of coercive measures, 78% of examinee believes that spatial conditions do not meet or partially meet safety standards, 69% of examinee did not participate in education, 72% of examinee stated that an imminent danger was the most common reason for using coercive measures. Conclusions: In order to prevent the use of coercive measures in psychiatry and to prevent negative consequences, it is necessary to conduct continuous education of health professionals regarding the use of deescalation, recognition of triggers and early signs of aggression, increase the number of staff and to improve spatial conditions.

coercive measures ; nurses ; education

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