AUTHOR=Ye Junrong , Xia Zhichun , Wang Chen , Liao Yao , Xu Yu , Zhang Yunlei , Yu Lin , Li Sijue , Lin Jiankui , Xiao Aixiang 

TITLE=Effectiveness of CRSCE-Based De-escalation Training on Reducing Physical Restraint in Psychiatric Hospitals: A Cluster Randomized Controlled Trial

JOURNAL=Frontiers in Psychiatry

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.576662

DOI=10.3389/fpsyt.2021.576662

ISSN=1664-0640

ABSTRACT=<p><bold>Background:</bold> The use of physical restraint (PR) causes clinical and ethical issues; great efforts are being made to reduce the use of PR in psychiatric hospitals globally.</p><p><bold>Aim:</bold> This study aimed to examine the effectiveness of CRSCE-based de-escalation training on reducing PR in psychiatric hospitals.</p><p><bold>Method:</bold> The proposed study adopted cluster randomized controlled trial design. Twelve wards of a psychiatric hospital were randomly allocated to experimental group (<italic>n</italic> = 6) and control group (<italic>n</italic> = 6). Wards of control group were assigned to routine training regarding PR; wards of experimental group underwent the same routine training while additionally received CRSCE-based de-escalation training. Before and after CRSCE-based de-escalation training, the frequency of and the duration of PR, and the numbers and level of unexpected events caused by PR, were recorded.</p><p><bold>Results:</bold> After CRSCE-based de-escalation training, the frequency (inpatients and patients admitted within 24 h) of and the duration of PR of experimental group, showed a descending trend and were significantly lower than those of control group (<italic>P</italic> &lt; 0.01); compared to control group, the numbers of unexpected events (level II and level III) and injury caused by PR of experimental group had been markedly reduced (<italic>P</italic> &lt; 0.05).</p><p><bold>Conclusions:</bold> CRSCE-based de-escalation training would be useful to reduce the use of PR and the unexpected event caused by PR in psychiatric hospitals. The modules of CRSCE-based de-escalation training can be adopted for future intervention minimizing clinical use of PR.</p><p><bold>Clinical Trial Registration:</bold> This study was registered at Chinese Clinical Trial Registry (Registration Number: ChiCTR1900022211).</p>