ELearning course may shorten the duration of mechanical restraint among psychiatric inpatients:
A cluster-randomized trial
Sammanfattning
Background : The management of psychiatric inpatients exhibiting severely disturbed and
aggressive behaviour is an important educational topic. Well structured, IT-based educational
programmes (eLearning) often ensure quality and may make training more affordable and
accessible. Aims : The aim of this study was to explore the impact of an eLearning course for
personnel on the rates and duration of seclusion and mechanical restraint among psychiatric
inpatients. Methods : In a cluster-randomized intervention trial, the nursing personnel on
10 wards were randomly assigned to eLearning (intervention) or training-as-usual (control)
groups. The eLearning course comprised six modules with specifi c topics (legal and ethical
issues, behaviour-related factors, therapeutic relationship and self-awareness, teamwork and
integrating knowledge with practice) and specifi c learning methods. The rates (incidents per
1000 occupied bed days) and durations of the coercion incidents were examined before and
after the course. Results : A total of 1283 coercion incidents (1143 seclusions [89%] and 140
incidents involving the use of mechanical restraints [11%]) were recorded on the study wards
during the data collection period. On the intervention wards, there were no statistically
signifi cant changes in the rates of seclusion and mechanical restraint. However, the duration of
incidents involving mechanical restraints shortened from 36.0 to 4.0 h (median) ( P 0.001).
No statistically signifi cant changes occurred on the control wards. Conclusions : After our
eLearning course, the duration of incidents involving the use of mechanical restraints decreased.
However, more studies are needed to ensure that the content of the course focuses on the most
important factors associated with the seclusion-related elements. The eLearning course deserves
further development and further studies. The duration of coercion incidents merits attention in
future research.