Highlights
- •Seclusion use was influenced by the presence of senior nurse positions.
- •Nursing staff to patient ratios did not have a statistically significant influence on seclusion use.
- •Seclusion events increased on shifts with a higher presence of registered nurses.
- •No significant associations were identified between overtime rates per shift and use of seclusion.
- •No statistically significant relationship was found between staff gender and the use of seclusion.
Abstract
Introduction
Research on the influence of nursing staff composition and use of seclusion in the
forensic mental health inpatient settings is sparse. Nursing staff composition refers
to staffing levels, roles, gender ratio and skill mix of the ward teams. Internationally,
the rates of seclusion in some forensic mental health inpatient settings have increased
over the past 10 years despite global efforts to reduce and eliminate its use.
Aim
To examine whether the use of seclusion in a forensic mental health inpatient setting
can be attributed to staffing composition or to contextual factors such as day of
the week, month or other clinical factors.
Method
Retrospective data collection was conducted using seclusion data, daily ward reports
and staff rosters. Data were collected for all shifts in the hospital over a six-month
period.
Results
Three staffing variables were identified as having an influence on the use of seclusion:
the number of registered nurses on duty, the presence of the shift coordinator and
having a lead nurse on shift.
Discussion
Senior nurse oversight and guidance are important factors in assisting staff to identify
clinical deterioration and intervene early which may assist services reduce the use
of seclusion.
Implications for practice
As staffing levels and composition are modifiable, the results of this study may assist
nurse leaders to consider workforce improvements to reduce seclusion use.
Keywords
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Article info
Publication history
Published online: September 30, 2022
Accepted:
September 19,
2022
Received in revised form:
September 19,
2022
Received:
August 14,
2021
Identification
Copyright
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