Physical Restraints in an Italian Psychiatric Ward: Clinical Reasons and Staff Organization Problems

PURPOSE: To analyze physical restraint use in an Italian acute psychiatric ward, where mechanical restraint by belt is highly discouraged but allowed. DESIGN AND METHODS: Data were retrospectively collected from medical and nursing charts, from January 1, 2005, to December 31, 2008. Physical restraint rate and relationships between restraints and selected variables were statistically analyzed. FINDINGS: Restraints were statistically significantly more frequent in compulsory or voluntary admissions of patients with an altered state of consciousness, at night, to control aggressive behavior, and in patients with "Schizophrenia and other Psychotic Disorders" during the first 72 hr of hospitalization. PRACTICAL IMPLICATIONS: Analysis of clinical and organizational factors conditioning restraints may limit its use.