(DRAFT) Hours of physical restraint use


	(DRAFT) Hours of physical restraint use
	The total number of hours that all patients admitted to a hospital-based inpatient psychiatric setting were maintained in physical restraint.
	
	
		
		
	
	
	
	
      
  			
				
				Joint Commission
				
			
		
	
	
      
  			
				
				Joint Commission
				
			
		
	
	
      
  			
				
				Joint Commission
				
			
		
	
	
		
			
			Improvement Noted As: A decrease in the rate
		
	
	
		
			
			
		
	
	
		
			
			
		
	
	
		
			
			Mental health providers that value and respect an individual’s autonomy, independence and safety seek to avoid the use of dangerous or restrictive interventions at all times (Donat, 2003). The use of seclusion and restraint is limited to situations deemed to meet the threshold of imminent danger and when restraint and seclusion are used; such use is rigorously monitored and analyzed to prevent future use. Providers also seek to prevent violence or aggression from occurring in their treatment environments by focusing their attention on prevention activities that have a growing evidence base (Donat, 2003).
		
	
	
		
			
			Donat, D. (August, 2003). An analysis of successful efforts to reduce the use of seclusion and restraint at a public psychiatric hospital. Psychiatric Services. 54(8): 1119-1123.
		
	
	
		
			
			Fisher, W. A. (2003). Elements of successful restraint and seclusion reduction programs and their application in a large, urban, state psychiatric hospital. Journal of Psychiatric Practice, 9(1), 7-15.
		
	
	
		
			
			None
		
	
	
		
			
			Hospital-Based Inpatient Psychiatric Services (HBIPS)
		
	
	
	
	
		
			
			Data criteria
			
				
					
						Age >= 1: 
						Age is greater than or equal to 1.
					
					
						Restraint event: 
						An event where the subject is maintained in physical restraint.
					
					
						Psychiatric inpatient encounter: 
						An encounter, where encounter type <= value set PsychiatricInpatientEncounter.
					
					
						On leave from psychiatric inpatient encounter: 
						A status where patient is on approved leave of absence from a psychiatric inpatient encounter. 
					
				
			
		

	
	
	
		
			
			Population criteria
			
				
					
						Initial Patient Population = 
 
					AND: Inpatient encounter where
						
							AND: Psychiatric inpatient encounter.
						
					
					
						Numerator =

					AND: Inpatient encounter where
						
							AND: Psychiatric inpatient encounter;
							AND: Restraint event;
							AND: Age >= 1.
						
					
				
			
		

	
	
	
		
			
			Measure observations
			
				
					
					Psychiatric inpatient encounter duration = 

					 (TODAY - PsychiatricInpatientEncounter.effectiveTime.low) -

					 SUM(OnLeaveFromPsychiatricInpatientEncounter.effectiveTime.duration).
					
					
					Restraint time = 

					 SUM(RestraintEvent.effectiveTime.duration).