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International Journal of Emergency Mental Health and Human Resilience | ISSN: 1522-4821 | Volume: 20
July 25-26, 2018 | Vancouver, Canada
Psychiatric & Mental Health Nursing
14
th
World Congress on
Mental Health and Wellbeing
5
th
World Congress on
&
Restraints alternatives in the management of challenging behaviors in inpatients with autism and
intellectual disability
Lefèvre-Utile J
a,b
, Guinchat V
a
, Wachtel LE
c
, Cohen Da,d, Perron A
e
, Montreuil M
f
, Carnevale FA
f
, Reyre Ag
h
a
Department of Child and Adolescent Psychiatry, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie, 47 bd de l’Hopital, 75013
Paris, France
b
Research Department of ethics, EA 1610 Etudes sur les sciences et les techniques (EST), Paris-Sud University, 63 rue Gabriel Péri, 94276 Le Kremlin-Bicêtre,
France.
Introduction:
In intensive and emergency psychiatry units, caregivers are often faced with severe behavioral disturbances,
including self-injury, aggression and extreme psychomotor agitation. The associated risk of harm is highly problematic. While
the use of restrictive measures is common, it optimally should be limited.
Objectives:
To review the myriad forms of personal protective equipment in current use, including helmets, gloves, sleeves,
jackets, bodysuits, mats, splints, padded shields, papoose boards, etc. and describe their usage through caregiver experiences.
Methods:
A focused ethnography based on the observation, justification and formalization of personal protective equipment
and procedures used as an alternative to restraint, focusing on caregivers' representations of violent patient encounters. The
research was a multi-centered study in three psychiatric inpatient units in Canada, the USA and France dedicated to the
assessment and treatment of challenging behaviors in individuals with autism and intellectual disability.
Results:
Numerous forms of personal protective equipment (PPE) exist, and their usage can confer a safe alternative to the
containment of behavioral crises. Appropriate handling of challenging, recurring behaviors is imperative to the preservation of
physical and moral integrity in both patient and caregiver.
Conclusion:
Personal protective equipment (PPE) decreases harm associated with the management of challenging behaviors,
and can promote respect for individual integrity and fundamental rights. The usage of PPE can be extremely helpful in
challenging and dangerous behaviors, and subsequent provision of personalized and efficacious therapy.
jean.lefevreutile@gmail.comLefèvre-Utile J et al., IJEMHHR 2018, Volume: 20
DOI: 10.4172/1522-4821-C3-018