Improving the confidence and competence of junior doctors in conducting seclusion reviews

AIMS: To improve the quality and consistency of medical seclusion reviews at St Charles Hospital and across the Trust. To ensure at least 80% compliance with minimum standards for seclusion review documentation by the end of December 2020. To increase doctors' mean perceived competence and confidence scores to 4.5/5 by the end of December 2020. METHOD: : A lack of consistent local or national guidance for junior doctors undertaking seclusion reviews. The quality and scope of these reviews is not consistent. There may be a need to ensure that there is more standardization and to improve junior doctors' confidence – and therefore patient safety and experience – overall. The following interventions were used to improve the quality of seclusion reviews at the hospital: Minimum standard guidelines. Presenting in Restrictive interventions meeting. Feedback from PICU consultants for guidelines. Changing guidelines. Guidelines teaching (Early November). Re-audit and new survey (Early November). Simulation training (Mid November). Seclusion teaching video (Early December- to be ready for Induction). Re-audit and new survey (Beginning of April). RESULT: Surveys were conducted before and after quality improvement interventions were put in place. The average confidence levels of junior doctors increased from 38.5% to 87% following these interventions. CONCLUSION: Revision of seclusion guidelines, junior doctor teaching and simulation training are effective interventions to improve junior doctor confidence levels in conducting seclusion reviews.