An evaluation of the implementation of Safewards on an assessment and treatment unit for people with an intellectual disability

Abstract

This study evaluates the implementation of Safewards on an assessment and treatment unit (ATU) for people with an intellectual disability. There are no previous studies evaluating this model in this context and previous research has focused largely on acute mental health services. The ‘Patient–Staff Conflict Shift Report’ was used at baseline for 1 month and 1 year later, after all the interventions had been implemented, to evaluate the impact of Safewards. Significant reductions were found in conflict and containment measures used within the service after the implementation of Safewards. Staff who led on the interventions were also asked to give feedback on their experiences, the challenges they faced and how they would like to move forward. Safewards was generally seen as a positive approach by the team. Limitations of this study are highlighted and suggestions for future research are made.

Effect of Safewards on reducing conflict and containment and the experiences of staff and consumers: A mixed‐methods systematic review

“…2018), seven quasi‐experimental before and after designs (Cabral & Carthy 2017; Davies et al . 2020; Fletcher et al . 2017; Hottinen et al .…”

Reducing aggression in psychiatric wards using Safewards—A Polish study

“…As such, generalization to other types of diagnoses requires exploration. A future study might need other types of wards involved, such as a recent study in a facility for people with intellectual disabilities 16 . There is also a need for a longitudinal study to confirm if reductions in the restraint rate are sustainable over time.…”

“…Initially, Safewards was used in acute psychiatric wards, but now its effectiveness is has been documented for other groups, also 13‐16 . The Safewards model offers ten techniques to reduce the likelihood of conflict: Clear mutual expectations concern the creation of partnership‐based principles that apply to all, Soft words are short statements to indicate to personnel the methods of avoiding hot spots, Talk down is a poster summarizing advanced techniques reducing tension, Positive words consists of positive reinforcement of patient behaviors, Breaking bad news is personnel anticipating difficult situations for the patients and strategizing the best way to share with the patient, Knowing each other involves creating brief statements about patients and staff as individuals, including noncontroversial information publicly available, Mutual help meeting is a voluntary meeting wherein they discuss how staff and patients can help each other throughout the day, Calm down box is a set of relaxing or distracting tools offered when patients are tense or upset, allowing a substitute for sedatives, Reassurance requires translating the reasons for discomfort among patients, such as being a witness of restraints placed on another patient, and Discharge messages are created by patients to provide tips to help future patients 17…”

“…Currently, Safewards is used in England, 12,14,16 Germany, 13 Denmark, 15 Sweden, 10 Australia, 18 and the United States 19 . Previous use of Safewards has reported reductions of 2% to 40% in the use of coercive measures 10,12,13,15,18,20,21 .…”

“…12 Initially, Safewards was used in acute psychiatric wards, but now its effectiveness is has been documented for other groups, also. [13][14][15][16] The Safewards model offers ten techniques to reduce the likelihood Currently, Safewards is used in England, 12,14,16 Germany, 13 Denmark, 15 Sweden, 10 Australia, 18 and the United States. 19 Previous use of Safewards has reported reductions of 2% to 40% in the use of coercive measures.…”