The Safewards Model and I.R.O.N. Interventions in a No-Restraint Ward

Area of Science:

• Psychiatry
• Mental Health Care
• Patient Safety

Background:

• The psychiatry inpatient ward of Trento (SPDC) operates with an open-door policy, emphasizing a recovery-oriented approach.
• Professionals adopt the patient's perspective as a "person," granting autonomy and responsibility.
• The SPDC is a no-restraint ward, prioritizing relational restraint over physical restraint.

Purpose of the Study:

• To introduce and describe the I.R.O.N. (no-restraint-oriented relational interventions) interventions.
• To highlight the methods used to de-escalate patient agitation and resolve crises.
• To emphasize the importance of teamwork, determination, and patience in psychiatric care.

Main Methods:

• Introduction of I.R.O.N. interventions in 2022 for patient agitation.
• Employing "gentle" yet "iron" methods to ease tension and resolve crises.
• Documenting intervention strategies in a register and sharing them with the work team.

Main Results:

• Successful implementation of I.R.O.N. interventions in managing patient agitation.
• Increased focus on relational strategies and reduced reliance on physical restraint.
• Recognition of staff commitment through "IRON parchment" and "Talk Down Champion" awards.

Conclusions:

• The no-restraint approach, coupled with I.R.O.N. interventions, enhances patient recovery and safety.
• Relational strategies are effective in de-escalating crises in psychiatric settings.
• Teamwork and consistent application of these methods are crucial for successful outcomes.