Nursing Staff's Perceptions of Patient Safety in Psychiatric Inpatient Care

Kanerva, Anne; Lammintakanen, Johanna; Kivinen, Tuula

doi:10.1111/ppc.12098

Cited by 21 publications

(33 citation statements)

References 29 publications

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“…Safety in nursing practice constitutes protecting patients from harms arising from adverse events in care such as medication errors, poor communication in handover, insufficient staffing or inadequate education on new technologies (Sherwood, ). However, within mental health care, discussions of patient safety issues resulting from harms of the health care environment are limited (Kanerva, Lammintakanen, & Kivinen, ) and are often replaced by the notion of patient risk: the harms that a patient creates within the environment including violence, aggression, self‐harm or suicide (Bowers et al., ; Crowe & Carlyle, ; De Santis et al., ). In contrast to other hospital environments, within psychiatric inpatient settings, patient risk is conceptualized as affecting not only the individual, but also other patients, staff and the general public, widening the sphere of risk.…”

Section: Introductionmentioning

confidence: 99%

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice

2017

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The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self‐harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re‐centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re‐evaluating the risk management culture that gives rise to and legitimizes harmful practices.

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Section: Introductionmentioning

confidence: 99%

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice

2017

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“…Implementation of PSC improves clinical practices; for example, the introduction of PSC has been linked to reductions in adverse events/errors (El‐Jardali, Dimassi, Jamal, Jaafar, & Hemadeh, ; Mardon, Khanna, Sorra, Dyer, & Famolaro, ; Robb & Seddon, ; Singer et al, ; Wang et al, ) and an improvement in certain clinician behaviours such as error reporting (Verbakel, Langelaan, Verheij, Wagner, & Zwart, ). In psychiatric care, culture has been identified as a critical patient safety factor (Kanerva, Lammintakanen, & Kivinen, ; True, Frasso, Cullen, Hermann, & Marcus, ; Vandewalle et al, ). Systematic reviews have found that healthcare organisations looking to improve PSC apply various strategies that directly involve the managers, including team‐based training programs, executive walk rounds, educational activities or training programs (Morello et al, ; Weaver et al, ).…”

Section: Introductionmentioning

confidence: 99%

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

et al. 2019

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Aim To evaluate how a 3‐year patient safety intervention, more specifically, the implementation of a patient safety incident reporting system, influences patient safety culture. Background Positive patient safety culture improves both the quality of health care and patient safety. Nevertheless, nursing managers need tools that can help them develop and evaluate patient safety culture. Methods The Hospital Survey on Patient Safety Culture was used to evaluate patient safety culture at two Finnish forensic psychiatric hospitals (study and control) over two periods, baseline and follow‐up. Data were analysed using Z‐score and T test statistics. Results The follow‐up results from the study hospital showed that five patient safety culture dimensions exhibited a significantly (p < 0.05) positive change in positive response rates over the 3‐year period. Furthermore, nine out of twelve patient safety culture dimensions at the study hospital showed a significant improvement in mean score. At the control hospital, only the dimension of frequency of reporting events showed a significantly positive change (p < 0.05) in mean score. Conclusion This research shows that the studied patient safety intervention (implementation of the patient safety incident reporting system) significantly influences patient safety culture. Implications for Nursing Management Nursing managers should utilize a variety of patient safety interventions to improve patient safety and focus on leveraging information from patient safety incidents to advance patient safety culture.

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“…Enhancing this understanding is necessary in order to support the potential of psychiatric nurses to facilitate the participation of patients in patient safety (Kanerva et al . ).…”

Section: Introductionmentioning

confidence: 97%

“…However, the empirical understanding of factors influencing this collaborative behaviour is limited in the context of care provided by psychiatric nurses. Enhancing this understanding is necessary in order to support the potential of psychiatric nurses to facilitate the participation of patients in patient safety (Kanerva et al 2014).…”

Section: Introduction Backgroundmentioning

confidence: 99%

Patient safety on psychiatric wards: A cross‐sectional, multilevel study of factors influencing nurses' willingness to share power and responsibility with patients

Vandewalle

Malfait

Eeckloo

et al. 2017

Int J Mental Health Nurs

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The World Health Organization highlights the need for more patient participation in patient safety. In mental health care, psychiatric nurses are in a frontline position to support this evolution. The aim of the present study was to investigate the demographic and contextual factors that influence the willingness of psychiatric nurses to share power and responsibility with patients concerning patient safety. The patient participation culture tool for inpatient psychiatric wards was completed by 705 nurses employed in 173 psychiatric wards within 37 hospitals. Multilevel modelling was used to analyse the self-reported data. The acceptance of a role wherein nurses share power and responsibility with patients concerning patient safety is influenced by the nurses' sex, age, perceived competence, perceived support, and type of ward. To support nurses in fulfilling their role in patient participation, patient participation-specific basic and continuing education should be provided. Managers and supervisors should recognize and fulfil their facilitating role in patient participation by offering support to nurses. Special attention is needed for young nurses and nurses on closed psychiatric wards, because these particular groups report being less willing to accept a new role. Ward characteristics that restrict patient participation should be challenged so that these become more patient participation stimulating. More research is needed to explore the willingness and ability of psychiatric nurses to engage in collaborative safety management with patients who have specific conditions, such as suicidal ideation and emotional harm.

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Nursing Staff's Perceptions of Patient Safety in Psychiatric Inpatient Care

Abstract: The views of the nurses contribute to formalization of organizational policies and strategies. In particular, they highlight the importance of continual training for the staff and management, considering patients' views, and treating patients as collaborators in their care.

Cited by 21 publications

References 29 publications

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

Patient safety on psychiatric wards: A cross‐sectional, multilevel study of factors influencing nurses' willingness to share power and responsibility with patients

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