Seattle University Collaborative Projects - International Academy of ...

others argue staff shortage leads to more seclusion. Studies show flexible personnel, unfamiliarto the ward and team, may induce aggression in wards. Personnel planning depends primarily onthe distribution of financial means. It remains unclear to what extent personnel planning isrelated to the severity of the patient population at the ward. Methods and materials: In anationwide benchmark study into coercion, information into personnel planning was gathered.Of all admitted patients data on diagnosis, global assessment of functioning, age, sex and ethnicbackground were gathered. Diagnosis was transformed into a severity index. These data wereincluded in a single database and univariate and multi level analyses were performed. Results:Seclusion rates at ward level varied from less than 1 up to 157 hours per bed hour. Wards withlower rates contained more patients with anxiety and mood disorders, and as well as a higherGAF (mean=47). Wards with higher seclusion rates contained more patients with bipolardisorders and schizophrenia and a lower GAF (mean=40). The number of nurses varied littlebetween wards with high and low rates despite a clear difference in patient severity. Personnelplanning seemed not related to patient severity. Conclusions: This study showed that structuraladjustment of personnel deployment to patient severity may possibly prevent seclusion. Thisimplies that organisations need to develop instruments for monitoring patient severity as well ascare intensity allowing the adjustment of personnel deployment. Criteria have to be set,warranting one to one or one to two nursing support.Associations between Short Term Structured Risk Assessment Outcomes andSeclusionR. van de Sande, (Roland.vandesande@hu.nl)E.O. NoorthoornA.I. Wierdsma,E.M. Hellendoorn,C. van der Staak,C.L. Mulder.H.L.I. NijmanBackground: Seclusion as a routine intervention to manage dangerous behavior is still in use atmany acute psychiatric wards around the world. Apart from the therapeutic value of thisintervention, the objectivity of clinical decisions on whether to seclude or not, may bequestioned. Research findings indicate that symptoms and behavior of acutely admitted patientsfluctuate drastically within hours and that structured daily risk assessment canreduce the risk of aggressive incidents and duration of seclusion. Goal: The aim was to study theassociations between scores on two, daily administered structured observation tools (BrøsetViolence Checklist and the Kennedy Axis V) and seclusion. Methods: Patient characteristicswere gathered from hospitals databases. Nurses daily scored two scales on self-control andglobal patient functioning, using the Brøset Violence Checklist and the Kennedy Axis V. Datawere analysed using multi-level techniques. Results: In this study, 7403 risk assessments (BVC's338