Post-Seclusion and/or Restraint Review in Psychiatry: A Scoping Review.

CONTEXT: It has been suggested that after an incident in which a patient has been placed in seclusion or in restraints, an intervention should be conducted after the event to ensure continuity of care and prevent recurrences. Several terms are used, and various models have been suggested for post-seclusion and/or restraint review; however, the intervention has never been precisely defined.

OBJECTIVE: This article presents a scoping review on post-seclusion and/or restraint review in psychiatry to examine existing models and the theoretical foundations on which they rely.

METHOD: A scoping review of academic articles (CINAHL and Medline database) yielded 28 articles.

RESULTS: Post-seclusion and/or restraint review has its origins in the concepts of debriefing in psychology and reflective practice in nursing. We propose a typology in terms of the intervention target, including the patient, the health care providers, or both.

IMPLICATIONS: The analysis found that the review ought to involve both the patient and the care providers using an approach that fosters reflexivity among all those involved in order to change the practice of seclusion in psychiatric settings.

ACCESSIBLE SUMMARY: • Established literature documented widely that seclusion and restraint has adverse physical and psychological consequences for patient and for health care providers. • Post-seclusion and/or restraint review is promoted in most guidelines, but there is no scoping or systematic review yet on the subject. • The origins of post-seclusion and/or restraint review are in the concepts of debriefing in psychology and reflective practice in nursing. • We propose that post-seclusion and/or restraint review should focus on both patients and health care providers.• Systematic post-seclusion and/or restraint review should be performed after each event, and its effects on patients and on mental health professionals should be rigorously assessed.