The use of restraint in four general hospital emergency departments in Australia

Objective: The purpose of this study was to investigate restraint use in Australian emergency departments (EDs). Method: A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011). Results: The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained patients had a mental illness diagnosis and were compulsorily hospitalised. Mechanical restraint with the use of soft shackles was the main method used. Restraint was enacted to prevent harm to self and/or others. Median incident duration was 2 hours 5 minutes. Conclusions: In order to better integrate the needs of mental health clients, consideration is needed as to what improvements to procedures and the ED environment can be made. EDs should particularly focus on reducing restraint duration and the use of hard shackles.