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Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial

Bowers, L., James, K., Quirk, A., Simpson, A., SUGAR, ., Stewart, D. and Hodsoll, J. (2015). Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial. International Journal of Nursing Studies, 52(9), pp. 1412-1422. doi: 10.1016/j.ijnurstu.2015.05.001

Abstract

Please see http://openaccess.city.ac.uk/13908/ for details of the Corrigendum to this article.

Background: Acute psychiatric wards manage patients whose actions may threaten safety (conflict). Staff act to avert or minimise harm (containment). The Safewards model enabled the identification of ten interventions to reduce the frequency of both.

Objective: To test the efficacy of these interventions.

Design: A pragmatic cluster randomised controlled trial with psychiatric hospitals and wards as the units of randomisation. The main outcomes were rates of conflict and containment.

Participants: Staff and patients in 31 randomly chosen wards at 15 randomly chosen hospitals.

Results: For shifts with conflict or containment incidents, the experimental condition reduced the rate of conflict events by 15% (95% CI 5.6–23.7%) relative to the control intervention. The rate of containment events for the experimental intervention was reduced by 26.4% (95% CI 9.9–34.3%).

Conclusions: Simple interventions aiming to improve staff relationships with patients can reduce the frequency of conflict and containment.

Trial registration: IRSCTN38001825

Publication Type: Article
Publisher Keywords: Absconding; Inpatient; Psychiatry; Rapid tranquillisation; Restraint; Seclusion; Self harm; Special observation; Violence
Subjects: R Medicine > RT Nursing
Departments: School of Health Sciences > Nursing
URI: http://openaccess.city.ac.uk/id/eprint/12210
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