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TE POU LIMITED TRADING AS TE POU
Strategies to
reduce the use of
seclusion and
restraint with
tāngata whai i te
ora September 2013
2 Strategies to reduce the use of seclusion and restraint
3 Strategies to reduce the use of seclusion and restraint
Acknowledgments
4 Strategies to reduce the use of seclusion and restraint
Contents
Acknowledgments ................................................................................................. 3
Executive summary ............................................................................................... 5
Introduction ........................................................................................................ 7
Literature review ................................................................................................. 8 Māori mental health statistics ......................................................................................................... 8 Seclusion and restraint ................................................................................................................ 10 Tāngata whai i te ora experiences of seclusion and restraint ................................................................... 11 Factors associated with seclusion and restraint ................................................................................... 11 Guidelines to reduce seclusion and restraint ....................................................................................... 12 Recovery-orientated services ......................................................................................................... 16 Cultural assessment and cultural competency ..................................................................................... 17 Summary ................................................................................................................................. 18
Methodology ..................................................................................................... 19
Findings ........................................................................................................... 21 Te ao Māori: access to a Māori worldview .............................................................................. 21 Te ao hurihuri (whakaumutia): transforming practice ................................................................ 26 Rangatiratanga: leadership, power, and control....................................................................... 32 Summary ...................................................................................................................... 33
Discussion ........................................................................................................ 35 Limitations .................................................................................................................... 37
Conclusion ........................................................................................................ 38
Glossary ........................................................................................................... 39
References ....................................................................................................... 41
5 Strategies to reduce the use of seclusion and restraint
Executive summary
Recommendations for clinicians in inpatient mental health services
6 Strategies to reduce the use of seclusion and restraint
Recommendations for leaders and managers of inpatient mental health services
7 Strategies to reduce the use of seclusion and restraint
Introduction
Project aims
Objectives
8 Strategies to reduce the use of seclusion and restraint
Literature review
Māori mental health statistics
9 Strategies to reduce the use of seclusion and restraint
Admissions:
Readmissions:
Length of stay:
10 Strategies to reduce the use of seclusion and restraint
Diagnosis:
Involuntary admissions:
Seclusion and restraint
11 Strategies to reduce the use of seclusion and restraint
Tāngata whai i te ora experiences of seclusion and restraint
Factors associated with seclusion and restraint
12 Strategies to reduce the use of seclusion and restraint
Guidelines to reduce seclusion and restraint
Leadership towards organisational change:
13 Strategies to reduce the use of seclusion and restraint
The use of data to inform practice:
Workforce development:
14 Strategies to reduce the use of seclusion and restraint
Use of seclusion and restraint prevention tools:
Practical prevention methods:
15 Strategies to reduce the use of seclusion and restraint
Sensory modulation:
16 Strategies to reduce the use of seclusion and restraint
Service user roles in inpatient services
Debriefing:
Recovery-orientated services
17 Strategies to reduce the use of seclusion and restraint
Cultural assessment and cultural competency
18 Strategies to reduce the use of seclusion and restraint
Summary
19 Strategies to reduce the use of seclusion and restraint
Methodology
Research design
Participants
Procedure
20 Strategies to reduce the use of seclusion and restraint
Data collection
Data analysis
21 Strategies to reduce the use of seclusion and restraint
Findings
Te ao Māori: access to a Māori worldview
Ensuring a Māori presence and the availability of Māori healing environments at services
22 Strategies to reduce the use of seclusion and restraint
Sustaining existing helpful Māori cultural practices and processes during the inpatient stay
23 Strategies to reduce the use of seclusion and restraint
24 Strategies to reduce the use of seclusion and restraint
25 Strategies to reduce the use of seclusion and restraint
Providing whānau-centred care
26 Strategies to reduce the use of seclusion and restraint
Te ao hurihuri (whakaumutia): transforming practice
Acknowledging past trauma and history
27 Strategies to reduce the use of seclusion and restraint
Creating and sustaining changes in practice
28 Strategies to reduce the use of seclusion and restraint
29 Strategies to reduce the use of seclusion and restraint
Addressing challenges to implementing change
30 Strategies to reduce the use of seclusion and restraint
31 Strategies to reduce the use of seclusion and restraint
32 Strategies to reduce the use of seclusion and restraint
Rangatiratanga: leadership, power, and control
Participation of Māori at all levels
33 Strategies to reduce the use of seclusion and restraint
Leadership commitment to transforming practice
Summary
Leadership towards organisational change:
The use of data to inform practice:
Workforce development:
34 Strategies to reduce the use of seclusion and restraint
Use of seclusion and restraint prevention tools:
Practical interventions:
Sensory modulation:
Service user roles in inpatient services:
Debriefing:
35 Strategies to reduce the use of seclusion and restraint
Discussion
Implications for clinicians in inpatient mental health services
Recommendations for clinicians in inpatient mental health services
36 Strategies to reduce the use of seclusion and restraint
Implications for sector leaders and managers of inpatient mental health services
Recommendations for sector leaders and managers of inpatient mental health services
37 Strategies to reduce the use of seclusion and restraint
Limitations
38 Strategies to reduce the use of seclusion and restraint
Conclusion
39 Strategies to reduce the use of seclusion and restraint
Glossary
40 Strategies to reduce the use of seclusion and restraint
41 Strategies to reduce the use of seclusion and restraint
References
42 Strategies to reduce the use of seclusion and restraint
43 Strategies to reduce the use of seclusion and restraint
44 Strategies to reduce the use of seclusion and restraint
45 Strategies to reduce the use of seclusion and restraint
ā
46 Strategies to reduce the use of seclusion and restraint
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