Minimisation of violent incidents and of unnecessary coercive measures in acute inpatient treatment of patients with serious psychiatric disorders or states. Mental and Behavioural Disorders
Conditions
Interventions
All patients referred to acute ward care from an admissions ward or psychiatric intensive care unit (PICU) are randomly allocated to either:
1. Two wards with an open-door policy service model that pr
Sponsors
Lovisenberg Diakonale Sykehus
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adults aged 18 - 65 years 2. Referred to acute psychiatric ward from a psychiatric intensive care unit (PICU)
Exclusion criteria
Exclusion criteria: 1. Forensic category patient (assessed as having a high risk of committing violence) 2. Police or criminal justice custody patient without legal option to utilise the open-door service
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of patient stays with one or more coercive measures (including involuntary medication, isolation/seclusion, mechanical- or manual/physical restraints) is measured by summarising registered coercive measures per study arm in patient records at 12 months (RCT), and (observational) 24, 36, and 48 months | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Violent events, including suicides, are measured using the hospital incident registry at 12 months, 24, 36, and 48 months 2. Individual coercive measures (including medications, seclusion, mechanical or manual/physical restraints) are measured using patient records and summarised at 12 months, 24, 36, and 48 months 3. Duration of separate involuntary/coercive measures are measured in patient records at 12 months (RCT), and (observational) 24, 36, and 48 months 4. Patients' experience of coercion and treatment environment are measured by patient-reported experience measures (PREMs) continuously and summarised at 12 months, 24, 36, and 48 months 5. Absconding from inpatient care is measured in the patient records of all involuntarily admitted patients at 12 months (RCT), and (observational) 24, 36, and 48 months 6. Type and extent of in-building use of illicit substances and alcohol abuse is measured by continuous on-site measuring of substances and metabolites in wastewater and comparing this to baseline (2020) samples. 7. Type and extent of pharmaceutical treatments are measured by patient records at 12 months (RCT), and (observational) 24, 36, and 48 months 8. The amount of time main doors are open to patients (as opposed to locked due to emergencies) is measured using in-ward door records at 12 months (RCT), and (observational) 24, 36, and 48 months | — |
Countries
Norway
Contacts
Public ContactHans Martin Nussle
Outcome results
None listed