Biomaterial Database

Weekend prescribing practices and subsequent seclusion and restraint in a psychiatric inpatient setting. 2010

David Lee Goldbloom, and Ramin Mojtabai, and Michael J Serby

Department of Psychiatry, Beth Israel Medical Center, First Ave. and 16th St., New York, NY 10003, USA. dgoldblo2002@yahoo.com

OBJECTIVE This case-control study examined the role of early medication management in preventing seclusion and restraint. METHODS Data were extracted from the medical records, including whether standing medication was increased, decreased, or left unchanged during the first 48 hours of hospitalization. RESULTS Compared with inpatients who did not experience seclusion or restraint (N=39), those who did (N=39) were younger (p=.01) and more likely to be male (p=.023) and to have a primary discharge diagnosis of bipolar disorder, mixed or manic episode, schizophrenia, or schizoaffective disorder (p<.001). Patients whose standing medication was not changed during the first 48 hours of hospitalization had 5.5 times as many restraints as patients whose dose was increased or who received new prescriptions (p=.027). CONCLUSIONS Early use of medication can reduce the incidence of seclusion and restraint among high-risk patients early in their hospitalization.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009519	New York City	City located at the mouth of the Hudson River, in New York State.
D010356	Patient Isolation	The segregation of patients with communicable or other diseases for a specified time. Isolation may be strict, in which movement and social contacts are limited; modified, where an effort to control specified aspects of care is made in order to prevent cross infection; or reverse, where the patient is secluded in a controlled or germ-free environment in order to protect him or her from cross infection.	Home Isolation,Isolation, Home,Isolation, Patient,Negative Pressure Isolation,Negative Pressure Patient Isolation
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D011567	Psychiatric Department, Hospital	Hospital department responsible for the organization and administration of psychiatric services.	Hospital Psychiatric Department,Psychiatric Departments, Hospital,Department, Hospital Psychiatric,Departments, Hospital Psychiatric,Hospital Psychiatric Departments
D011618	Psychotic Disorders	Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994)	Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D012149	Restraint, Physical	Use of a device for the purpose of controlling movement of all or part of the body. Splinting and casting are FRACTURE FIXATION.	Immobilization, Physical,Physical Restraint,Physical Immobilization,Physical Restraints,Restraints, Physical
D004305	Dose-Response Relationship, Drug	The relationship between the dose of an administered drug and the response of the organism to the drug.	Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004334	Drug Administration Schedule	Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.	Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration