Weekend prescribing practices and subsequent seclusion and restraint in a psychiatric inpatient setting

Objective: This case-control study examined the role of early medication management in preventing seclusion and restraint. Methods: Data were extracted from the medical records, including whether standing medication was increased, decreased, or left unchanged during the first 48 hours of hospitalization. Results: Compared with inpatients who did not experience seclusion or restraint (N=39), those who did (N=39) were younger (p=.01) and more likely to be male (p=.023) and to have a primary discharge diagnosis of bipolar disorder, mixed or manic episode, schizophrenia, or schizoaffective disorder (p<.001). Patients whose standing medication was not changed during the first 48 hours of hospitalization had 5.5 times as many restraints as patients whose dose was increased or who received new prescriptions (p=.027). Conclusions: Early use of medication can reduce the incidence of seclusion and restraint among high-risk patients early in their hospitalization.