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.
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.
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 specific topics (legal and ethical issues, behaviour-related factors, therapeutic relationship and self-awareness, teamwork and integrating knowledge with practice) and specific learning methods. The rates (incidents per 1000 occupied bed days) and durations of the coercion incidents were examined before and after the course.
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 significant 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
To examine the association between hospitals' organizational variables and patients' perceptions of individualized care.
There is lack of evidence related to the effects that the hospital environment has on patient perceptions of the individuality of care they receive.
A cross-sectional design was used. The questionnaire survey data were obtained from 861 (response rate 82%) hospital patients and 35 (100%) nurse managers in Finland. Results An inverse relationship between the size of the hospital and ward and patients' perceptions of individualized care was found. Increased staffing or skill mix failed to predict a higher patient perception of individualized care, but primary nursing care delivery did.
Instead of increasing the amount of nursing staff, there is a need to improve the quality of the nurse-patient interactions to facilitate individualized care. The generalizability of the study is limited by the regional nature of the setting.
The purposes of this study were to examine how hospital patients' backgrounds and clinical illness are related to their perceptions of the individualized care they receive and to test the sensitivity of the Individualized Care Scale (ICS). Cross-sectional explorative survey data were obtained using questionnaires completed by 861 (response rate = 88%) predischarge hospital patients from six hospitals in Southern Finland in 2004. Self-administered questionnaires included the ICS as well as the 15D, a measure of health-related quality of life, and gathered information about the patients' backgrounds. Based on association tests, younger age, poorer state of health, and higher level of education were associated with more critical perceptions of individualized care. Using simultaneous regression analysis and presenting the results from stronger to weaker, we found age to be the strongest predictor of patients' positive perceptions of the individualized care they received. This was followed by health-related quality of life (HRQoL) as measured by the 15D, vocational education, and type of admission. The ICS was found to be a valid tool for the measurement of individualized care in hospitals. The self-reported patient data from this survey suggest that some patient characteristics are associated with the patients' perceptions about the individualized care they receive. There is now a need to consider how these characteristics can be taken into account in nursing care delivery to increase individualized care for hospital patients. The results also support use of the ICS in the measurement of individualized care in hospitals.