The effects of a changing culture on a child and adolescent psychiatric inpatient unit.

OBJECTIVES: To examine the impact of restructuring a child and adolescent psychiatry inpatient unit on reportable incidents (including verbal or physical aggression), seclusion, security, constant observation, sick leave and lengths of stay. METHODS: Data was collected regarding a seven-bed child and adolescent psychiatric unit between 2008 and 2010, comparing data from 2008 and 2009 (before) to 2010 (after). RESULTS: Occurrences, sick leave, security, seclusion and constant observation all decreased in 2010 compared to 2008 and 2009, although only the decrease in constant observation was statistically significant. Length of stay was not affected. CONCLUSIONS: A broad representation of multidisciplinary team members, increased consistency and improved communication may be associated with reductions in reportable incidents, seclusion, security and constant observation.