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Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit

BACKGROUND: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door...

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Autores principales: Hochstrasser, Lisa, Voulgaris, Alexander, Möller, Julian, Zimmermann, Tatjana, Steinauer, Regine, Borgwardt, Stefan, Lang, Undine E., Huber, Christian G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834654/
https://www.ncbi.nlm.nih.gov/pubmed/29535651
http://dx.doi.org/10.3389/fpsyt.2018.00057
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author Hochstrasser, Lisa
Voulgaris, Alexander
Möller, Julian
Zimmermann, Tatjana
Steinauer, Regine
Borgwardt, Stefan
Lang, Undine E.
Huber, Christian G.
author_facet Hochstrasser, Lisa
Voulgaris, Alexander
Möller, Julian
Zimmermann, Tatjana
Steinauer, Regine
Borgwardt, Stefan
Lang, Undine E.
Huber, Christian G.
author_sort Hochstrasser, Lisa
collection PubMed
description BACKGROUND: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door status is still unclear. AIMS: The aims of this study is to examine the transition from closed to predominantly open doors on a psychiatric intensive care unit (PICU) and its associations with the frequency of seclusion and forced medication. METHOD: A PICU at the Department of Adult Psychiatry, University of Basel, Switzerland, implemented evidence-based strategies for operating an open door policy within the context of acute psychiatry and participated in a hospital-wide implementation of an open door policy before changing door status. 131 inpatient cases hospitalized on this PICU were examined regarding the frequency of seclusion and forced medication using explorative analyses over a time span of 32 weeks (16 weeks after implementation of the new treatment concept but before door opening, 16 weeks after door opening). RESULTS: Following door status change, the PICU was completely open on 51% of the days and partly open on 23% of the days. The mean number of open hours per day was 12.8 ± 3.9 h. The frequency of forced medication did not change, and the frequency of seclusion decreased significantly [χ(2) (1, N = 131) = 4.73, p = 0.036]. CONCLUSION: This pilot study underlines the potential of a change of door status to attain a reduction in safety measures in the first 4 months.
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spelling pubmed-58346542018-03-13 Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit Hochstrasser, Lisa Voulgaris, Alexander Möller, Julian Zimmermann, Tatjana Steinauer, Regine Borgwardt, Stefan Lang, Undine E. Huber, Christian G. Front Psychiatry Psychiatry BACKGROUND: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door status is still unclear. AIMS: The aims of this study is to examine the transition from closed to predominantly open doors on a psychiatric intensive care unit (PICU) and its associations with the frequency of seclusion and forced medication. METHOD: A PICU at the Department of Adult Psychiatry, University of Basel, Switzerland, implemented evidence-based strategies for operating an open door policy within the context of acute psychiatry and participated in a hospital-wide implementation of an open door policy before changing door status. 131 inpatient cases hospitalized on this PICU were examined regarding the frequency of seclusion and forced medication using explorative analyses over a time span of 32 weeks (16 weeks after implementation of the new treatment concept but before door opening, 16 weeks after door opening). RESULTS: Following door status change, the PICU was completely open on 51% of the days and partly open on 23% of the days. The mean number of open hours per day was 12.8 ± 3.9 h. The frequency of forced medication did not change, and the frequency of seclusion decreased significantly [χ(2) (1, N = 131) = 4.73, p = 0.036]. CONCLUSION: This pilot study underlines the potential of a change of door status to attain a reduction in safety measures in the first 4 months. Frontiers Media S.A. 2018-02-26 /pmc/articles/PMC5834654/ /pubmed/29535651 http://dx.doi.org/10.3389/fpsyt.2018.00057 Text en Copyright © 2018 Hochstrasser, Voulgaris, Möller, Zimmermann, Steinauer, Borgwardt, Lang and Huber. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Hochstrasser, Lisa
Voulgaris, Alexander
Möller, Julian
Zimmermann, Tatjana
Steinauer, Regine
Borgwardt, Stefan
Lang, Undine E.
Huber, Christian G.
Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit
title Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit
title_full Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit
title_fullStr Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit
title_full_unstemmed Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit
title_short Reduced Frequency of Cases with Seclusion Is Associated with “Opening the Doors” of a Psychiatric Intensive Care Unit
title_sort reduced frequency of cases with seclusion is associated with “opening the doors” of a psychiatric intensive care unit
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834654/
https://www.ncbi.nlm.nih.gov/pubmed/29535651
http://dx.doi.org/10.3389/fpsyt.2018.00057
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