Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Bowers, Len; James, Karen; Quirk, Alan; Simpson, Alan; Stewart, Duncan; Hodsoll, John; SUGAR, c, 1
• Is Part Of: International journal of nursing studies. Volume 52:Issue 9(2015:Sep.)
• Page Start: 1412
• Page End: 1422
• Publication Date: 2015-09
• Subjects: Nursing -- Periodicals; Nursing -- Periodicals; Soins infirmiers -- Périodiques; Nursing; Periodicals; 610.73
• DOI: 10.1016/j.ijnurstu.2015.05.001
• Languages: English
• ISSNs: 0020-7489

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Background</title> <p id="spar0005">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.</p> </sec> <sec> <title id="sect0015">Objective</title> <p id="spar0010">To test the efficacy of these interventions.</p> </sec> <sec> <title id="sect0020">Design</title> <p id="spar0015">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.</p> </sec> <sec> <title id="sect0025">Participants</title> <p id="spar0020">Staff and patients in 31 randomly chosen wards at 15 randomly chosen hospitals.</p> </sec> <sec> <title id="sect0030">Results</title> <p id="spar0025">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%).</p> </sec> <sec> <title id="sect0035">Conclusions</title> <p id="spar0030">Simple interventions aiming to improve staff relationships with patients can reduce the frequency of conflict and containment.</p> </sec> <sec> <title id="sect0040">Trial registration</title> <p id="spar0035">IRSCTN38001825.</p> </sec> </abstract>