Overcrowding in Psychiatric Wards is Associated With Increased Risk of Adverse Incidents
| Autor: | Gad Lubin, Alexander Teitelbaum, Monica Gun-Usishkin, Nitza Calfon, Amnon Lahad, Anat Tsur |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Occupancy Poison control Psychiatric Department Hospital Occupational safety and health 03 medical and health sciences 0302 clinical medicine Risk Factors Injury prevention medicine Humans Psychiatric hospital 030212 general & internal medicine Israel Psychiatry Bed Occupancy Retrospective Studies Hospitals Public business.industry Public Health Environmental and Occupational Health Retrospective cohort study Overcrowding medicine.disease 030227 psychiatry Aggression Crowding Socioeconomic Factors Accidental Falls Female Medical emergency business |
| Zdroj: | Medical Care. 54:296-302 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/mlr.0000000000000501 |
| Popis: | To study the association between bed occupancy in psychiatric wards and rate of adverse incidents (AIs) including aggressive behavior and falls.This is a retrospective study analyzing bed occupancy and AIs' data in 4 closed wards in a state psychiatric hospital in Israel over a 20-month period. Ward-level daily records were extracted from the hospital's electronic admission-discharge and AI registries, creating a log of 609 days for each of the 4 wards. Relationships between gross and net bed occupancy and AIs rate were calculated, in general and for each ward and type of incidents.Average gross occupancy was 106±14.8% and net occupancy was 96.4±15.6%. Gross occupancy100% was recorded in 51% of days. Net occupancy was higher on days with at least 1 incident than on no-incident days (98.6±14.8% vs. 95.7±15.7%, P0.0001). AIs occurred in 18.6% of days in the lowest occupancy quadrant (up to 85% occupancy), compared with 26.7% of days in the highest occupancy quadrant (106% and above). Moreover, aggressive behavior-type incidents were significantly lower in the lowest occupancy quadrant days compared with the highest occupancy quadrant (8.3% vs. 14.1%, P0.01). Evidence of a dose-response effect of bed occupancy on AIs rate was found.Overoccupancy is prevalent in psychiatric wards and is associated with an increased rate of aggressive AIs and falls. Policy makers should be convinced about the necessity to reduce overcrowding in psychiatric wards and to improve safety of inpatient facilities. |
| Databáze: | OpenAIRE |
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