Standard 5: Comprehensive Care

Minimising restrictive practices: seclusion

Action 5.36

Where seclusion is clinically necessary to prevent harm and is permitted under legislation, the health service organisation has systems that:

a. Minimise and, where possible, eliminate the use of seclusion

b. Govern the use of seclusion in accordance with legislation

c. Report use of seclusion to the governing body

Intent

Harm relating to the use of seclusion is minimised.

Reflective questions

What strategies does the health service organisation have in place to minimise the use of seclusion?

How does the health service organisation ensure that the workforce is competent in implementing de-escalation strategies?

What processes (for example, benchmarking, routine review) are used to review the use of seclusion in the health service organisation?

Key tasks

  • Implement strategies to minimise the use of seclusion.

  • Ensure that seclusion is only implemented by members of the workforce who have been trained to implement it safely.

  • Monitor and document appropriate observations during and subsequent to seclusion.

  • Review the use of seclusion within the health service organisation.

Strategies for improvement

Hospitals

Seclusion is the confinement of a patient, at any time of the day or night, alone in a room or area from which free exit is prevented.1

The strategies to minimise the use of restraint (see Action 5.35) also apply to seclusion, as both are restrictive practices. Ensure that the workforce is trained in de-escalation skills, implement routine observations of the person in seclusion, and provide for the person’s physical needs and dignity.

The use of seclusion in mental health services is governed by state and territory legislation and mandatory policy. This typically includes designated processes for reporting and review of the use of seclusion, at local unit, hospital, local health network, state or territory, and national levels. Links to current state and territory legislation are provided in the Resources section at the end of this standard.

The use of seclusion outside designated mental health services is unlawful, and health service organisations should ensure that it does not occur.

Day Procedure Services

This action is not applicable for day procedure services. Day procedure services are not gazetted under relevant legislation to use seclusion.

MPS & Small Hospitals

Review the use of seclusion within the health service organisation. Implement strategies to minimise the use of seclusion and ensure that seclusion is only implemented by members of the workforce who have been trained to implement it safely.

Seclusion is the confinement of a patient, at any time of the day or night, alone in a room or area from which free exit is prevented.2

The strategies to minimise the use of restraint (see Action 5.35) also apply to seclusion, as both are restrictive practices. Ensure that the workforce is trained in de-escalation skills, implement routine observations of the person in seclusion, and provide for the person’s physical needs and dignity.

The use of seclusion in mental health services is governed by state and territory legislation and mandatory policy. This typically includes designated processes for reporting and review of the use of seclusion, at local unit, hospital, local health network, state or territory, and national levels. Links to current state and territory legislation are provided in the Resources section at the end of this standard.

The use of seclusion outside designated mental health services is unlawful, and health service organisations should ensure that it does not occur.

Last updated 29th May, 2018 at 11:51pm
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References

Australian Institute of Health and Welfare. Mental health services in Australia: key concepts. Canberra: AIHW; 2012 [cited 2015 Jun 5].