Abstract
Seclusion is a practice that is used in mental health settings to manage aggressive behaviors exhibited by patients when they are unwell. Nurses use this intervention to ensure the safety of other patients and colleagues. There has been calls from the international human rights organisations to eliminate the practice. Some countries around the world have been implementing initiatives to reduce seclusion use. Seclusion is linked to negative consequences to both the nurses and patients.
Research question: This integrative review will provide a description the views of mental health nurses toward seclusion use and the barriers to reducing seclusion?
Aim/Objective:
1. To understand the perspectives of mental health nurses toward seclusion use.
2. To understand the barriers to reducing seclusion from the mental health nurses' perspective.
Method: An Integrative review of qualitative research articles was conducted. Thematic analysis was used to analyse the data that was extracted from the primary research articles.
Findings: Ensuring safety in mental health settings was found to have a profound effect on the use of seclusion. It was found that inadequate staffing, lack of training in de-escalation techniques and overcrowded environments can increase seclusion rates. Nurses reported lack of supervision and debriefing post seclusion events. Organisation culture plays a major role in seclusion use. Nurse's ethnicity and culture can impact on decision making with regards to seclusion use. Nurse patient relationships can either increase or reduce seclusion. Physical considerations of a patient and their presenting problem on admission determines whether seclusion will be used or not. Leaders of organisations have a vital role of ensuring that resources are available to support seclusion reduction initiatives.
Seclusion as an intervention used in mental health settings has negative consequences to both nurses and patients. Seclusion is applied by mental health nurses to protect and ensure the safety of colleagues and patients on the ward. Nurses stated that they use seclusion as a last resort when other alternatives have failed to de-escalate patients. Some countries around the world have implemented initiatives to eliminate the practice as well as repealing their mental health laws. Human rights organisations have made calls to abolish the practice.