Is a No-Restraint Policy Associated with Increased Aggression Towards Healthcare Professionals Among Inpatient Psychiatric Units? A 16-Year Retrospective Observational Study Conducted in Italy
2024

No-Restraint Policy and Aggression in Psychiatric Units

Sample size: 113 publication 10 minutes Evidence: moderate

Author Information

Author(s): Colizzi Marco, Comacchio Carla, Garzitto Marco, Napoli Giovanni, Battiston Chiara, Tam Tatiana, Bertoli Marco, Anzallo Calogero, Palese Alvisa, Balestrieri Matteo, Yobas Piyanee (Klainin), Bressington Daniel

Primary Institution: University of Udine

Hypothesis

Is a no-restraint policy associated with increased aggression towards healthcare professionals in inpatient psychiatric units?

Conclusion

Adopting a no-restraint policy is not associated with increased aggression toward staff in psychiatric healthcare in the longer term.

Supporting Evidence

  • 113 accidents were recorded over the study period, mostly related to physical aggression.
  • Healthcare assistants and psychiatric nurses were the most affected by workplace accidents.
  • A transitory peak of accidents occurred during the policy transition.
  • More accidents occurred during the morning shift than during afternoon and night shifts.
  • Accidents were significantly associated with the professional role of the healthcare workers.

Takeaway

This study looked at whether not using restraints in psychiatric hospitals leads to more violence against staff. It found that while there was a temporary increase in incidents during the policy change, overall, it didn't lead to more aggression in the long run.

Methodology

A retrospective observational study analyzing workplace accidents related to aggression in a psychiatric unit from 2007 to 2022.

Potential Biases

Potential for spurious associations due to the observational nature of the study.

Limitations

Data was collected from a single service, limiting the ability to compare with other units that continued to use restraints.

Participant Demographics

101 healthcare professionals, including registered nurses, psychiatric nurses, healthcare assistants, and ward doctors.

Statistical Information

P-Value

p < 0.001

Confidence Interval

95% CI

Statistical Significance

p < 0.001

Digital Object Identifier (DOI)

10.3390/nursrep14040276

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