Staff training decreases use of seclusion and restraint in an acute psychiatric hospital

Rates of seclusion and restraint in an urban psychiatric hospital were compared during the 12-month periods before and after implementing the recommendations of a multidisciplinary quality improvement work-group convened to reduce the hospital's use of physical containment. Interventions included a mandatory staff training session on the management of assaultive behavior, weekly discussion items during team meetings for each local ward, and hospital-wide publicity charting the ongoing progress of the effort. Total annual rates of restraint dropped 13.8%. The average duration of restraint per admission decreased 54.6%. Staff injuries were reduced by 18.8% during the study period.