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Investigation into the acceptability of door locking to staff, patients, and visitors on acute psychiatric wards

Muir-Cochrane, E., van der Merwe, M., Nijman, H., Haglund, K., Simpson, A. and Bowers, L. (2012). Investigation into the acceptability of door locking to staff, patients, and visitors on acute psychiatric wards. International Journal Of Mental Health Nursing, 21(1), pp. 41-49. doi: 10.1111/j.1447-0349.2011.00758.x

Abstract

There is disagreement among psychiatric professionals about whether the doors of acute psychiatric wards should be kept locked to prevent patients from leaving and harming themselves or others. This study explored patient, staff, and visitor perceptions about the acceptability of locking the ward door on acute psychiatric inpatient wards. Interviews were conducted with 14 registered nurses, 15 patients, and six visitors from three different acute wards. Findings revealed commonalities across all groups, with general agreement that locking the door reduced absconding. Staff expressed feelings of guilt, embarrassment, and fear of being blamed when a patient absconded. Staff also reported that open wards created anxious vigilance to prevent an abscond and increased workload in allocating staff to watch the door, whereas staff on partially-locked doors also perceived an increased workload in letting people in and out of the ward. Patients had mixed feelings about the status of the door, expressing depression, a sense of stigma, and low self-esteem when the door was locked. The issue of balancing safety and security on acute psychiatric wards against the autonomy of patients is not easily resolved, and requires focused research to develop innovative nursing practices.

Publication Type: Article
Additional Information: This is the accepted version of the following article: Muir-Cochrane, E., van der Merwe, M., Nijman, H., Haglund, K., Simpson, A. and Bowers, L. (2012), Investigation into the acceptability of door locking to staff, patients, and visitors on acute psychiatric wards. International Journal of Mental Health Nursing, 21: 41–49., which has been published in final form at http://dx.oi.org/10.1111/j.1447-0349.2011.00758.x
Publisher Keywords: absconding, acute psychiatric ward, locked door
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RT Nursing
Departments: School of Health Sciences > Nursing
Related URLs:
URI: http://openaccess.city.ac.uk/id/eprint/5642
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