Document Detail


Event sequencing of forced intramuscular medication in England.
MedLine Citation:
PMID:  22296323     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ACCESSIBLE SUMMARY: •  In many countries staff are allowed to inject psychiatric inpatients against their will with psychotropic medication. •  This study, conducted in England, found such injections were given to 9% of patients, usually in response to aggressive behaviour or medication refusal. •  In most cases the forced injections ended a crisis, but the study concludes that there are opportunities for staff to use alternative approaches. ABSTRACT: In most inpatient psychiatric care systems it is permissible in certain situations for staff to forcibly inject patients with psychotropic medication. The aim of this study is to describe what precedes and follows a coerced intramuscular injection within a nursing shift. Data were collected on the sequence of conflict (aggression, absconding, etc.) and containment (seclusion, restraint, etc.) for the first 2 weeks of 522 acute admissions on 84 wards in 31 UK hospitals. Injections were given to 9% of patients. Aggression, regular medication refusal and pro re nata (PRN) medication refusal preceded injections. The giving of coerced medication concluded most crises. Coerced medication effectively resolves crises in the short term. Staff should offer oral PRN as an alternative, unless this is unsafe. Where only verbal violence has occurred staff should try to resolve the crisis without enforcing medication. More research on the best way to respond to inpatients' medication refusal is required.
Authors:
L Bowers; J Ross; J Owiti; J Baker; C Adams; D Stewart
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-1
Journal Detail:
Title:  Journal of psychiatric and mental health nursing     Volume:  -     ISSN:  1365-2850     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9439514     Medline TA:  J Psychiatr Ment Health Nurs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing.
Affiliation:
Professor of Psychiatric Nursing Research Assistant Research Fellow, Institute of Psychiatry, Kings College London Research Fellow, East London Foundation NHS Trust, Queen Mary University, London Lecturer, Manchester University, Manchester Chair of Mental Health Services Research, Nottingham University, Nottingham, UK.
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