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Aggression and violence in the ED: issues associated with the implementation of restraint and seclusion
Author(s) -
Zwan Rick,
Davies Lynn,
Andrews Doug,
Brooks Anna
Publication year - 2011
Publication title -
health promotion journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 32
eISSN - 2201-1617
pISSN - 1036-1073
DOI - 10.1071/he11124
Subject(s) - seclusion , aggression , context (archaeology) , medicine , emergency department , suicide prevention , occupational safety and health , poison control , medical emergency , workplace violence , nursing , psychiatry , paleontology , pathology , biology
A number of surveys have reported that those who work in emergency departments (EDs) experience high levels of violence and aggression. Some suggest that 100% of emergency department nurses have, at some time, experienced workplace violence. This report summarises those data and highlights the under‐reporting of violent incidents occurring in emergency departments. Current responses to such incidents are reviewed, with particular focus on the use of both unambiguous and ambiguous restraint practices and also on seclusion. Those practices are evaluated in the context of current policy. This review suggests that rather than continue with discussions about whether or not restraint and seclusion are appropriate management procedures in the emergency room, efforts should be directed towards development of best practice for initiating and managing the use of restraint when it is implemented. So what? If staff are implementing seclusion of any type then emergency departments must use practices consistent with the relevant mental health Legislation and that will increase burden on ED staff. Doing so, however, will provide a mechanism for ensuring appropriate management of patients requiring seclusion and will provide staff with both legal and ethical coverage.

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