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=Volume 12 - 2021

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=Background 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. 
Aim This study aimed to examine the effectiveness of CRSCE-based de-escalation training on reducing PR in psychiatric hospitals.
Method The proposed study adopted cluster randomized controlled trial design. Twelve wards of a psychiatric hospital were randomly allocated to experimental group (n=6) and control group (n=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. 
Results After CRSCE-based de-escalation training, the frequency (inpatients and patients admitted within 24 hours) of and the duration of PR of experimental group, showed a descending trend and were significantly lower than those of control group (P<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 (P<0.05). 
Conclusions 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.