Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study

Cutler, Natalie Ann; Sim, Jenny; Halcomb, Elizabeth; Moxham, Lorna; Stephens, Moira

doi:10.1111/jocn.15480

Cited by 26 publications

(39 citation statements)

References 42 publications

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“…The participants also emphasized how health professionals could enable or inhibit safety through their approach. Similarly, a recent Australian study found that therapeutic engagement with nurses was critical to fostering feelings of safety in mental health care (Cutler et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

‘What would a trauma‐informed mental health service look like?’ Perspectives of people who access services

Isobel

Wilson

Gill

et al. 2020

Int J Mental Health Nurs

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Trauma‐informed care is an approach to the delivery of mental health care based on an awareness of the high prevalence of trauma in the lives of people accessing mental health services, the effects of trauma experiences and the potential for trauma or re‐traumatization to occur in the context of care. Across Australia, inquiries and reports have increasingly indicated an urgent need for mental health services to become trauma‐informed. However, how Australian mental health services should deliver trauma‐informed care is not well documented. Efforts towards trauma‐informed care in any setting require engagement with those who receive care. This qualitative study used an experience‐based co‐design methodology to explore the perspectives of consumers of mental health services in Australia and their family members, in relation to the question ‘what would a trauma‐informed mental health service look like?’ Focus groups were held with consumers (n = 10) and carers (n = 10). Thematic analysis of transcripts identified that consumers and carers consider that trauma‐informed care requires increased awareness of trauma amongst mental health staff, opportunities to collaborate in care, active efforts by services to build trust and create safety, the provision of a diversity of models and consistency and continuation of care. The findings provide important new information about the experiences of Australian service users and have implications for the implementation of trauma‐informed care across settings.

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Section: Discussionmentioning

confidence: 99%

‘What would a trauma‐informed mental health service look like?’ Perspectives of people who access services

Isobel

Wilson

Gill

et al. 2020

Int J Mental Health Nurs

View full text Add to dashboard Cite

show abstract

“…Risk focused approaches to safety in acute units promote safety for staff, but do not sufficiently recognise consumers' safety needs (Shepley et al., 2016). Not having nurses close by, for example, reduces consumers' feelings of safety in these units (Cutler et al., 2020), and lack of engagement by staff can exacerbate consumer aggression (Salzmann‐Erikson & Yifter, 2019). Aspects of the built environment have also been seen to influence consumers' perception of quality of care (Liddicoat et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

“…The environment encompasses both the physical spaces of an acute unit and the social interactions and activities that occur within those physical spaces (Mollon, 2014). Other themes; Influence of Nurses (Cutler, Sim, Halcomb, Moxham, et al, 2020) and Being Seen as a Person (Cutler et al., 2020) are reported in separate papers due to the richness of the data.…”

Section: Introductionmentioning

confidence: 99%

How does the environment influence consumers' perceptions of safety in acute mental health units? A qualitative study

Cutler

Halcomb

Sim

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To explore how the physical and social environment of acute mental health units influences consumers' perception and experience of safety. Background Acute mental health units are places in which consumers should feel safe. Not all consumers, however, feel safe in this environment. Little is known about what contributes to consumers' feelings of safety in this setting. Design The study used a qualitative descriptive design, influenced by naturalistic enquiry. Data were analysed using thematic analysis and are reported according to the COREQ checklist. Methods Fifteen people who had experienced admission to an acute mental health unit were individually interviewed. Results Having a supportive environment enhanced consumers' perception and experience of safety. A supportive environment was experienced when consumers had privacy, felt safe from other consumers and had meaningful activities to participate in within the acute mental health unit. In contrast, having their privacy breached by other consumers made participants feel unsafe. Many participants were fearful of other consumers, and felt unsafe and unable to protect themselves. Lack of meaningful activities led to boredom and contributed to consumers feeling unsafe. Conclusions Personal spaces should address consumers' privacy needs without compromising staff access. Staff presence enhances consumers' feelings of safety, but this need can be heightened when consumers are unable to alert staff when they feel unsafe. Meaningful activities link consumers to their lives outside of the hospital and can enhance recovery. Relevance to clinical practice Understanding how the acute unit environment is perceived by consumers can assist nurses and managers to promote feelings of safety among consumers. Feeling safe can, in turn, optimise recovery.

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“…Given the complexity and depth of the data and the diversity of concepts explored in each key theme, they are reported separately (Cutler et al . 2020).…”

Section: Introductionmentioning

confidence: 99%

Understanding how personhood impacts consumers’ feelings of safety in acute mental health units: a qualitative study

Cutler

Sim

Halcomb

et al. 2020

Int J Mental Health Nurs

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Being admitted to an acute mental health unit can lead to feelings of shame, and loss of personhood for some consumers. Promoting safety for consumers is a function of acute mental health units. This paper explores how consumers’ personhood influences their perception and experience of safety in acute mental health units. Semi‐structured interviews were conducted with 15 participants who had previously been admitted to an acute mental health unit. Thematic analysis was used to analyse the data. Participants perceived safety as being intrinsically linked to their personhood. When participants’ innate worth was affirmed in their interactions with staff, participants felt safe. Three subthemes were identified: ‘Seen as an equal’, ‘Being respected’, and ‘Able to make choices’. These findings can be used to inform nursing practices that enhance consumers’ sense of personhood and, in so doing, promote consumers’ safety and recovery in acute mental health units.

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Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study

Cited by 26 publications

References 42 publications

‘What would a trauma‐informed mental health service look like?’ Perspectives of people who access services

‘What would a trauma‐informed mental health service look like?’ Perspectives of people who access services

How does the environment influence consumers' perceptions of safety in acute mental health units? A qualitative study

Understanding how personhood impacts consumers’ feelings of safety in acute mental health units: a qualitative study

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