Characteristics of patients with histories of multiple seclusion and restraint events during a single psychiatric hospitalization.

BACKGROUND: This descriptive, retrospective study examined patient and event characteristics associated with multiple seclusion and restraint (SR). OBJECTIVE: The goal was to identify patient characteristics of multiple seclusion and restraint users to improve patient care and decrease the need for seclusion or restraint. DESIGN: Medical charts were reviewed for 63 patients hospitalized at the Henry Phipps Psychiatric Service at the Johns Hopkins Hospital between January 2006 and December 2008 who had been secluded or restrained multiple times during a single hospitalization. Patient characteristics and events associated with multiple SR use were examined. Characteristics were then compared with those who had a single (n = 110) and no SR events (n = 3,585) during hospitalization in those study years. RESULTS: Compared with patients with no SR events, those with multiple SR events were more likely to be male, have histories of aggression before and during previous hospitalizations, and have longer lengths of stay. Patients with any SR event were more likely to have cognitive impairment and have been admitted involuntarily. CONCLUSIONS: Results highlight the need for practice changes targeting subgroups of patients at elevated risk for multiple SR use.

Using Yoga Nidra to Improve Stress in Psychiatric Nurses in a Pilot Study.

Given today's hurried and stressful heathcare system, nurses need mechanisms to take care of themselves, promote their own wellness, and build resilience in managing sick patients. Yoga is one such mechanism; it can decrease anxiety and improve sleep and quality of life. In this pilot study, nine nurses participated in 6 weekly sessions of yoga nidra. Measures of sleep, stress, and muscle fatigue were obtained to determine whether yoga had a positive impact upon quality of life and stress. Although based on a small sample of nurses, results indicated positive findings for both perceived stress level and muscle fatigue. This pilot study demonstrated the potential benefit of yoga in stress reduction, muscle tension, and self-care in nurses.