restraint

This study represents the second collection of data on the use of seclusion and restraint since the HCFA rules were instituted in 1999 and is the first to analyze rates and time trends specific to psychiatrically hospitalized children and adolescents.

Adjusted time trends The adjusted means and time trends for the use of seclusion and restraint during the study period are presented in Table 3 Table 3.

CONCLUSIONS: National reforms and institutional efforts can lead to downward trends in the use of seclusion and restraint among psychiatrically hospitalized youths.

In an effort to understand the driving components of changing trends, we derived quarterly tallies per 1,000 patient days and episode duration in minutes separately for seclusion and restraint episodes.

Admission status was the single strongest and most consistent predictor: youths who were admitted to the hospital on an emergency basis were 3.5 times as likely to undergo seclusion and 4.6 times as likely to undergo restraint.

There is even a tendency that the injury risk increases when children switch from one restraint system to another, i.e., are at the youngest ages for which the specific restraint is recommended.

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