Abstract
The purpose of this study was to assess the process of nursing care in relation to the use of seclusion and physical restraint among restless and excited psychiatric inpatients. Semi-structured interviews were conducted with 14 acute psychiatric ward nurses and the data were analyzed taking a modified grounded theory approach. Two categories and 13 concepts were established. The first category involved the "Process leading to seclusion and physical restraint." Concepts in this category included "Immediate judgments made to reduce restlessness and excitement," in which psychiatric nurses tried to calm restless and excited inpatients, and "Rapid cooperation of the medical team," during which the practice of seclusion and restraint was carried out. The second category, "Process to cease the use of seclusion and physical restraint," involved the period of time after patients had been secluded and physically restrained. Psychiatric nurses discussed processes that led to the release of inpatients from seclusion and physical restraint, including "Sharing various perspectives on ceasing seclusion and restraint treatment" and "Accumulating data concerning patient behavior." Concerning the nursing care use of seclusion and physical restraint, release should be decided as a result of medical team cooperation. In this study, rapid cooperation of the medical team enabled psychiatric nurses to cope with crisis situations and strengthen the information sharing network of the psychiatric ward.
