Evidence-Based Practice Initiative for Staff Training to Reduce Adult Psychiatric Inpatient Restraints & Injuries

Background: Violence against healthcare professionals is a growing phenomenon, and mental health care has the highest risk (Phillips, 2016). The experience of workplace violence is demoralizing, resulting in low job satisfaction, decrease productivity, physical injury, and potential Post-Traumatic Stress Disorder (Phillips, 2016; Howerton & Mentes, 2010). The Joint Commission and The Centers for Medicare and Medicaid identify patient perpetrated violence as a significant workplace risk, and they endorse education and training for risk reduction and safe intervention (The Joint Commission, 2018, 2019). Objective: The purpose of this evidence-based practice initiative was to evaluate the impact of staff training with the Safewards model on rates of restraint, and subsequent injuries, for patients and staff, on four inpatient psychiatric units in a large state hospital. Methods: This Evidence-Based practice initiative used a pre- and post-intervention design to evaluate the implementation of Safewards (Bowers, 2014). Hospital staff (n=128) were trained using a train-the-trainer model, and interventions were incorporated into unit practice over five weeks on four inpatient psychiatric units. Hospital risk data for rates of patient restraints and injuries for patients and staff were evaluated using the Wilcoxon signed-rank test. Results: There were no statistically significant differences between the medians of restraints and injuries pre- and post-Safewards implementation. Conclusions: Safewards (Bowers, 2014) is an evidence-based model of care to reduce patient violence. Training and implantation of the model on four inpatient psychiatric units did not yield statistically significant results after training, but a decrease trend in restraints was noted. Recommendations for continued use of interventions and mentorship to foster fidelity in use has the potential for long-term benefits on restraint and injury rate reductions (Fletcher et al., 2017)

Houses of Healing: A Group Intervention for Grieving Women in Prison

This study examines the impact of female inmate participation in a facilitator-led group on psychosocial (anxiety, depression, self-esteem) and spiritual well-being. A convenience sample of 36 women (21 intervention, 15 comparison) was recruited from a women\u27s prison in the Northeast. Participants in the groups described positive outcomes in the interviews and in the quantitative measurements of anxiety, depression, and self-esteem. Trends in the data, however, indicated an additional differential effect related to program involvement for depression and anxiety scores. The spirituality scores were high at all times for both groups, with slight increases over the period of the study. © 2009, SAGE Publications. All rights reserved

Characterizing Loss of Control Associated With Binge Eating in College-Age Men

BACKGROUND: The Diagnostic and Statistical Manual of Mental Disorders (5th ed.) identifies key features of binge eating (BE) to include the consumption of a large amount of food and the perception of loss of control (LOC) over eating during a distinct episode. While earlier research has focused on food consumption, findings are now emerging on the role of LOC associated with the BE episodes, particularly in women. However, it is unclear that these findings are applicable to men without knowing how men experience LOC associated with BE. AIMS: This study examined how college-age men describe LOC associated with BE. METHOD: Previously collected qualitative data from a study examining BE in college age-students were used to examine responses from 53 men (mean age 19.9 ± 1.1 [SD] years). Respondents were asked about their individual experiences of LOC associated with BE episodes. Data were analyzed using content analysis. RESULTS: Four categories emerged from the data: (1) keep eating, (2) can’t stop, (3) without thinking, and (4) food so good. CONCLUSIONS: Findings extend the current understanding of LOC associated with BE in men and point to potential gender differences, and/or weight influences, based on previous reports. Identified categories may be potentially targeted areas for tailored therapy to enhance awareness and self-regulation of BE behavior