Waiting room crowding and agitation in a dedicated psychiatric emergency service

BACKGROUND: Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services.

METHODS: The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month.

RESULTS: A total of 689 patients were seen in 31 days. The average hourly census was 6.8 ± 2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2 = 0.3, F = 5.47, P = .036).

CONCLUSION: Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.

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