@article{ref1,
title="Use of a"secure room"and a security guard in the management of the violent, aggressive or suicidal patient in a rural hospital: a 3-year audit",
journal="Canadian journal of rural medicine",
year="2009",
author="Brock, G. and Gurekas, Vydas and Gelinas, Anne-Fredrique and Rollin, Karina",
volume="14",
number="1",
pages="16-20",
abstract="Introduction: Little has been published on the management of psychiatric crises in rural areas, and little is known of the security needs or use of&quot;secure rooms&quot;in rural hospitals. Method: We conducted a 3-year retrospective chart audit on the use of our secure room/security guard system at a rural hospital in a town of 3500, located 220 km from our psychiatric referral centre. Results: Use of our secure room/security guard system occurred at the rate of 1.1 uses/1000 emergency department visits, with the most common indication being physician perception of risk of patient suicide or self-harm. Concern for staff safety was a factor in 10% of uses. Eighty percent of patients were treated locally, with most being released from the secure room after 2 days or less. Fourteen percent of patients required ultimate transfer to our psychiatric referral centre and 6% to a detoxification centre. The average annual cost of security was $16 259.61. Discussion: A secure room can provide the opportunity for close observation of a potentially self-harming patient, additional security for staff and early warning if a patient flees the hospital. Most admissions were handled locally, obviating the need for transfer to distant psychiatric referral centres. Most patients who were admitted were already known as having a psychiatric illness and 80% of the patients required the use of the secure room/security guard system for less than a 2-night stay, suggesting that most rural mental health crises pass quickly. Conclusion: Most patients admitted to a rural hospital with a mental health crisis can be managed locally if an adequate secure room/security guard system is available.<p /> <p>Language: en</p>",
language="en",
issn="1203-7796",
doi="",
url="http://dx.doi.org/"
}