Abstract
Background
Restrictive interventions (chemical, physical, or mechanical restraints) to manage
patients who are potentially or actually violent in the emergency department (ED)
can be harmful and costly. Non-restrictive interventions are advocated; but this must
be preceded with an understanding of patient characteristics that influence their
use. A study was conducted to describe the use of restrictive interventions and ascribe
it with patient characteristics in the ED.
Methods
Records from October 2020 to March 2021 in the occupational violence database were
used to analyse patient characteristics and restrictive interventions. Logistic regression
was used to establish influencing factors of restrictive interventions adjusting for
clinically relevant confounders.
Results
Of the N = 1276 potentially or actually violent patients, 70 % received restrictive
interventions. Chemical restraint was common, with 1 in 2 patients receiving either
oral medication or intramuscular injection. Probability of restrictive interventions
were higher in patients who were intoxicated [(adjusted odds ratio (aOR) 3.48, 95
% confidence interval (CI) 1.675–7.21)], had high triage score (aOR 2.084, 95 % CI
1.094–3.96), and were in the ED involuntarily (aOR 1.494, 95 % CI 1.105–2.020).
Conclusion
The results reveal the need for multifaceted approaches that limit the presentations
of, and minimise restrictive interventions among, potentially or actually violent
patients.
Keywords
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Article info
Publication history
Published online: July 23, 2022
Accepted:
July 3,
2022
Received in revised form:
July 3,
2022
Received:
March 28,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.
