Safewards implementation in residential aged care: a pilot and feasibility study

Area of Science:

• Gerontology
• Healthcare Management
• Nursing

Background:

• Restrictive practices in residential aged care (RAC) are a significant concern.
• Evidence-based interventions are needed to reduce conflict and restrictive practice use.
• The Safewards model, successful in mental health, offers a potential solution for RAC settings.

Purpose of the Study:

• To evaluate the feasibility of implementing the Safewards model in Australian residential aged care facilities.
• To assess the impact of Safewards interventions on the use of restrictive practices.

Main Methods:

• A pilot and feasibility study utilizing a mixed-methods approach.
• Implementation of Safewards interventions in two Australian care homes.
• Evaluation using the RE-AIM framework and the Consolidated Framework for Implementation Research (CFIR).

Main Results:

• Eight Safewards interventions were considered for RAC implementation; 3 were implemented at site 1 and 5 at site 2.
• Staff training attendance ranged from 28-52%.
• Physical restraint use decreased at site 2 but not site 1; implementation barriers were identified within CFIR domains.

Conclusions:

• Safewards implementation was feasible in RAC, with 5/8 interventions linked to reduced physical restraint use.
• Site-specific variations in reach, adoption, and leadership highlight the importance of contextual factors.
• Findings provide insights for future Safewards implementation in RAC settings.