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Safewards: Changes in conflict, containment, and violence prevention climate during implementation
Geoffrey L Dickens1, Tracy Tabvuma2, Steven A Frost2,3,4
1Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK.
International Journal of Mental Health Nursing
|July 22, 2020
Summary
The Safewards intervention significantly reduced conflict and containment incidents in Australian mental health wards. This package of interventions is recommended for widespread use in acute mental health services.
Area of Science:
- Mental Health Services Research
- Clinical Psychology
- Healthcare Quality Improvement
Background:
- The Safewards framework is a recognized intervention for mitigating conflict and containment in acute mental health settings.
- Its implementation and effectiveness in Australia had not been previously evaluated.
Purpose of the Study:
- To assess the impact of Safewards on conflict and containment incidents within an Australian mental health district.
- To evaluate the association between Safewards implementation and changes in the violence prevention climate.
Main Methods:
- A 24-week implementation of Safewards across eight acute mental health wards.
- Measurement of conflict and containment using the Patient-Staff Conflict Checklist Shift Report.
- Assessment of violence prevention climate using the validated VPC-14 tool.
Main Results:
- A significant reduction in reported conflict incidents (23.0%) and containment incidents (12.0%) per shift.
- No significant change was observed in the violence prevention climate ratings.
- Improvements were consistent across various incident severities and unaffected by response rates or ward characteristics.
Conclusions:
- Safewards implementation led to significant reductions in conflict and containment in acute mental health wards.
- The findings support Safewards as a valuable intervention for improving safety and reducing restrictive practices.
- Widespread adoption of Safewards in adult acute mental health services is recommended.
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