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

Len Bowers; Karen James; Alan Quirk; Alan Simpson; Duncan Stewart; John Hodsoll

doi:10.1016/j.ijnurstu.2015.05.001

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

Len Bowers
, Karen James
, Alan Quirk
, Alan Simpson
, Duncan Stewart
, John Hodsoll

Research output: Contribution to journal › Article › peer-review

Abstract

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

Original language	English
Pages (from-to)	1412-1422
Journal	International Journal of Nursing Studies
Volume	52
Issue number	9
Early online date	9 Jul 2015
DOIs	https://doi.org/10.1016/j.ijnurstu.2015.05.001
Publication status	Published - 30 Sept 2015

Bibliographical note

Note: This paper presents independent research funded by
the National Institute for Health Research (NIHR) under
its Programme Grants for Applied Research programme
(RP-PG-0707-10081).

Keywords

Health services research
Violence

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10.1016/j.ijnurstu.2015.05.001

James K 35259 VoRFinal published version, 408 KBLicence: CC BY

http://dx.doi.org/10.1016/j.ijnurstu.2015.05.001

Cite this

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title = "Reducing conflict and containment rates on acute psychiatric wards: the Safewards cluster randomised controlled trial",

abstract = "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",

keywords = "Health services research, Violence",

author = "Len Bowers and Karen James and Alan Quirk and Alan Simpson and Duncan Stewart and John Hodsoll",

note = "Note: This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (RP-PG-0707-10081).",

year = "2015",

month = sep,

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doi = "10.1016/j.ijnurstu.2015.05.001",

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T1 - Reducing conflict and containment rates on acute psychiatric wards

T2 - the Safewards cluster randomised controlled trial

AU - Bowers, Len

AU - James, Karen

AU - Quirk, Alan

AU - Simpson, Alan

AU - Stewart, Duncan

AU - Hodsoll, John

N1 - Note: This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (RP-PG-0707-10081).

PY - 2015/9/30

Y1 - 2015/9/30

N2 - 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

AB - 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

KW - Health services research

KW - Violence

UR - http://www.ncbi.nlm.nih.gov/pubmed/26166187

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DO - 10.1016/j.ijnurstu.2015.05.001

M3 - Article

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SN - 0020-7489

VL - 52

SP - 1412

EP - 1422

JO - International Journal of Nursing Studies

JF - International Journal of Nursing Studies

IS - 9

ER -

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

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Keywords

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