Serious Patient Safety Incidents in Psychiatric Inpatient Care: A Descriptive Register Study

Psychiatric units have often been underrepresented in patient safety research, limiting evidence on adverse events in psychiatric care.

This study aimed to describe reported serious patient safety incidents and preventive strategies in psychiatric inpatient care.

A retrospective multimethod register study design was applied to analyze data from 36 units in Finland between 2021 and 2023.

One hundred fifty‑two serious incidents were recorded, involving patient aggression, self‑harm, discontinuity in care, and injuries. These events contributed to prolonged treatment, unit transfers, restrictive interventions, deterioration in patient condition, increased staff workload, and organizational costs. Incidents were more frequent in adolescent units. Preventive strategies included improving care environments, standardizing practices, enhancing medication management, and strengthening staffing and competencies.

Serious incidents compromise patient safety and the quality of nursing care, underscoring the need for adequate resources, staff training, and interprofessional collaboration.