Reducing aggression in psychiatric wards using Safewards—A Polish study

Safewards is an internationally adopted framework that provides interventions to reduce conflict and containment in healthcare settings. This systematic review evaluated the effect of Safewards on conflict and containment events in inpatient units and the perceptions of staff and consumers. Quantitative, qualitative, and mixed‐methods studies were considered for inclusion. Following the Joanna Briggs Institute methodology, two reviewers independently screened, appraised, and extracted data. Qualitative data were synthesized using inductive‐thematic analysis. Quantitative and qualitative data were integrated with a convergent‐segregated approach and presented in tabular and narrative format. A search of 13 databases and grey literature yielded 14 studies of variable methodological quality. Four studies reported reduced rates of conflict and one study reported reductions that were not statistically significant. Six studies reported reductions in rates of containment, three studies found no statistical significance and one study reported statistically significant reductions at follow‐up. Staff and consumers in four studies reported an improved experience of safety. Three themes were developed as follows: (i) therapeutic hold, cohesion, support and the environment, (ii) conflict, containment and the experience of safety, and (iii) the complexities of adapting and embedding change. This review found most staff and consumers reported Safewards improved therapeutic relationships, cohesion, and ward atmosphere. Staff and consumers reported improved ward atmosphere, leading to consumer‐centred, recovery‐oriented care. Safewards improved the experience of safety from the perspective of staff and consumers when combined with ongoing training, leadership and time for consolidation. While results are promising they should be used cautiously until more robust evidence is established.

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“…2018; Lickiewicz et al . 2020; Maguire et al . 2018) and improving communication and relationships (Higgins et al .…”

Section: Discussionmentioning

confidence: 99%

“…2017; Lickiewicz et al . 2020), facilities for the intellectually disabled (Davies et al . 2020; Riding 2016) and emergency departments (Department of Health & Human Services 2020).…”

Section: Introductionmentioning

confidence: 99%

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

Ward-Stockham

Kapp

Jarden

et al. 2021

Int J Mental Health Nurs

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“…Numerous studies failed to provide a clear enough description of the setting (Cabral & Carthy, 2017;Stensgaard et al, 2018), their data collection procedure (Baumgardt et al, 2019;Cabral & Carthy, 2017;Lickiewicz et al, 2020;Price et al, 2016) and recruitment process (Baumgardt et al, 2019;Cabral & Carthy, 2017;Davies et al, 2020;Fletcher et al, 2019a;2019b;Price et al, 2016;Stensgaard et al, 2018) to allow for the research to be replicated.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

A Systematic Review of the Effectiveness of Safewards: Has Enthusiasm Exceeded Evidence?

Finch

Lawrence

Williams

et al. 2021

Issues in Mental Health Nursing

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Safewards is intended to be an evidence-based approach to reduce levels of conflict and containment in mental health inpatient settings. A systematic review was carried out to examine whether Safewards is effective in reducing conflict and containment events; and improving ward climate. Searches for articles evaluating the implementation of Safewards was conducted using Psych Info, PubMed, Web of Science, Cochrane Library and CINAHL.Thirteen studies were included for review after applying inclusion and exclusion criteria. The Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was used to assess study quality and the majority of studies (N = 7) were rated as "moderate" quality. Whilst there is evidence to suggest that Safewards is effective for reducing conflict and containment in general mental health services, there is insufficient high-quality empirical evidence to support its effectiveness in settings beyond this. Further research using robust methodological designs with larger, more representative samples is required in order for the effectiveness of Safewards to be established across the range of contexts in which it is currently being applied.

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“…Although the nursing staff are well‐trained, they are poorly paid, and work in overcrowded and sometimes unsanitary conditions (Sowada et al, 2019). Furthermore, it is of concern that in Polish mental hospitals, coercion is used on a regular basis, and not as a “last resort” (Lickiewicz et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…At present, there appears to be only one published study related to mental health care in Poland (Lickiewicz et al, 2021). Currently, we do not know how Polish psychiatric nurses view aggression and violence in the workplace, because there has been no instrument to measure their attitudes.…”

Section: Introductionmentioning

confidence: 99%

Attitudes of psychiatric nurses towards aggression: A polish study

Lickiewicz

Hughes

Makara‐Studzińska

2021

Psychiatric Ment Health Nurs

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What is known about the subject? (Scientific Rationale):• Mental health care in Poland lags behind that of many other countries, and coercive measures are used on a regular basis.• Scant research has been conducted in Poland regarding the treatment of psychiatric patients.• The perspectives of Polish psychiatric nurses towards aggression remain unknown. What does this paper add to the existing knowledge?:• The translated and validated Attitude Towards Aggression Scale (ATAS) in Polish will serve as an instrument that gauges Polish nurses' attitudes towards aggression. The Polish nurses have unenlightened and negative attitude towards aggression. What are the implications for practice?:• There is now an instrument in Polish by which we can gauge the attitudes of mental health nurses, which must precede any educational efforts. Polish nurses showed more restrictive and antiquated attitudes about patient violence than nurses in some other parts of the world. With a shift to more positive attitudes, the use of coercion could be reduced, resulting in improved patient care. Introduction:In Poland, the mode and site of patient treatment have changed little in the past 75 years, despite therapeutic advances worldwide. There is limited information regarding attitudes of nurses towards aggression in psychiatric settings in Poland, nor has there been an instrument in Polish to measure it.Aim: To translate and validate the Attitudes Towards Aggression Scale (ATAS) for use in Poland, and to assess the attitudes of three groups of nursing personnel towards aggression. Method:We surveyed 980 psychiatric and general nurses as well as nursing students.We translated the ATAS into Polish, and validated it using exploratory factor analysis. Results:The Polish version of the ATAS showed good psychometric properties. We found that Polish nurses perceived patient aggression extremely negatively. Discussion: Polish nurses perceive aggression as destructive, negative and not to be tolerated, leading to use of restraints. Among the three groups, psychiatric nurses | 857 LICKIEWICZ Et aL. How to cite this article: Lickiewicz J, Hughes PP, Makara-Studzinska M. Attitudes of psychiatric nurses towards aggression: A polish study.

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Reducing aggression in psychiatric wards using Safewards—A Polish study

Cited by 22 publications

References 26 publications

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

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

A Systematic Review of the Effectiveness of Safewards: Has Enthusiasm Exceeded Evidence?

Attitudes of psychiatric nurses towards aggression: A polish study

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