Sensory modulation and trauma-informed-care knowledge transfer and translation in mental health services in Victoria: Evaluation of a statewide train-the-trainer intervention

McEvedy, Samantha; Maguire, Tessa; Furness, Trentham; McKenna, Brian

doi:10.1016/j.nepr.2017.04.012

Cited by 19 publications

(49 citation statements)

References 30 publications

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“…Future research should focus on the intersection of Safewards and recovery-oriented practice on staff well-being and experiences at work. Further work is required to understand how Safewards interacts with other ward activities, such as sensory modulation (44, 45) and legislative coercion (46).…”

Section: Resultsmentioning

confidence: 99%

Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives

et al. 2019

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Introduction: Mental health professionals working in acute inpatient mental health wards are involved in a complex interplay between an espoused commitment by government and organizational policy to be recovery-oriented and a persistent culture of risk management and tolerance of restrictive practices. This tension is overlain on their own professional drive to deliver person-centered care and the challenging environment of inpatient wards. Safewards is designed to reduce conflict and containment through the implementation of 10 interventions that serve to improve the relationship between staff and consumers. The aim of the current study was to understand the impact of Safewards from the perspectives of the staff. Methods: One hundred and three staff from 14 inpatient mental health wards completed a survey 12 months after the implementation of Safewards. Staff represented four service settings: adolescent, adult, and aged acute and secure extended care units. Results: Quantitative results from the survey indicate that staff believed there to be a reduction in physical and verbal aggression since the introduction of Safewards. Staff were more positive about being part of the ward and felt safer and more connected with consumers. Qualitative data highlight four key themes regarding the model and interventions: structured and relevant; conflict prevention and reducing restrictive practices; ward culture change; and promotes recovery principles. Discussion: This study found that from the perspective of staff, Safewards contributes to a reduction in conflict events and is an acceptable practice change intervention. Staff perspectives concur with those of consumers regarding an equalizing of staff consumer relationships and the promotion of more recovery-oriented care in acute inpatient mental health services.

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Section: Resultsmentioning

confidence: 99%

Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives

et al. 2019

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“…No Force First 24,134 had been applied in three countries (i.e. Australia, England and the USA), as had Sensory Modulation [135][136][137] (Australia, Denmark and New Zealand) and Sensory Rooms 138 (Australia, England and the USA). The Brøset Violence Checklist 114 (Canada and Switzerland) and Patient Focused Nursing 104,139 (Australia and the USA) had each been applied in two countries.…”

Section: Geographical Settingmentioning

confidence: 99%

“…environment, ward functioning, staff presence, service user to staff ratios, quality of care, 'communication') (n = 11). Other common targets for improvement included safety (n = 18), service user behaviour ('dangerous', 'disruptive', 'risk', 'challenging', 'problem', 'aggression') (n = 26), 20,78,[112][113][114]118,129,136,137,141,[147][148][149][150][151][152][153][154][155][156] and staff skills and attitudes (n = 14). Three interventions targeted staff injury, 129,157 anxiety 141 and burnout, 70 whereas 14 targeted service user outcomes and experiences, including service user harm, 114 the service user experience (e.g.…”

Section: Assumed Change Process and Design Principlesmentioning

confidence: 99%

“…Many of the 'quality improvement' interventions used a plan, do, study, act (PDSA) cycle: a mechanism to repeat and adjust interventions until they achieve the desired effect. 12,16,17 Some interventions 130,137 made explicit cited reference to programme-level theories that had informed their intervention procedures, such as Sensory Modulation or Trauma-Informed Care. Other programmelevel theories cited sought to explain staff behaviour, service user behaviour, therapeutic relationships and organisational change.…”

Section: Reference To Theorymentioning

confidence: 99%

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Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review

Baker

Berzins

Canvin

et al. 2021

Health Serv Deliv Res

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Objectives The study aimed to provide a mapping review of non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings; classify intervention components using the behaviour change technique taxonomy; explore evidence of behaviour change techniques and interventions; and identify the behaviour change techniques that show most effectiveness and those that require further testing. Background Incidents involving violence and aggression occur frequently in adult mental health inpatient settings. They often result in restrictive practices such as restraint and seclusion. These practices carry significant risks, including physical and psychological harm to service users and staff, and costs to the NHS. A number of interventions aim to reduce the use of restrictive practices by using behaviour change techniques to modify practice. Some interventions have been evaluated, but effectiveness research is hampered by limited attention to the specific components. The behaviour change technique taxonomy provides a common language with which to specify intervention content. Design Systematic mapping study and analysis. Data sources English-language health and social care research databases, and grey literature, including social media. The databases searched included British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CCRCT), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), EMBASE, Health Technology Assessment (HTA) Database, HTA Canadian and International, Ovid MEDLINE®, NHS Economic Evaluation Database (NHS EED), PsycInfo® and PubMed. Databases were searched from 1999 to 2019. Review methods Broad literature search; identification, description and classification of interventions using the behaviour change technique taxonomy; and quality appraisal of reports. Records of interventions to reduce any form of restrictive practice used with adults in mental health services were retrieved and subject to scrutiny of content, to identify interventions; quality appraisal, using the Mixed Methods Appraisal Tool; and data extraction, regarding whether participants were staff or service users, number of participants, study setting, intervention type, procedures and fidelity. The resulting data set for extraction was guided by the Workgroup for Intervention Development and Evaluation Research, Cochrane and theory coding scheme recommendations. The behaviour change technique taxonomy was applied systematically to each identified intervention. Intervention data were examined for overarching patterns, range and frequency. Overall percentages of behaviour change techniques by behaviour change technique cluster were reported. Procedures used within interventions, for example staff training, were described using the behaviour change technique taxonomy. Results The final data set comprised 221 records reporting 150 interventions, 109 of which had been evaluated. The most common evaluation approach was a non-randomised design. There were six randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Behaviour change techniques found in the interventions were most likely to be those that demonstrated statistically significant effects. The most common intervention target was seclusion and restraint reduction. The most common strategy was staff training. Over two-thirds of the behaviour change techniques mapped onto four clusters, that is ‘goals and planning’, ‘antecedents’, ‘shaping knowledge’ and ‘feedback and monitoring’. The number of behaviour change techniques identified per intervention ranged from 1 to 33 (mean 8 techniques). Limitations Many interventions were poorly described and might have contained additional behaviour change techniques that were not detected. The finding that the evidence was weak restricted the study’s scope for examining behaviour change technique effectiveness. The literature search was restricted to English-language records. Conclusions Studies on interventions to reduce restrictive practices appear to be diverse and poor. Interventions tend to contain multiple procedures delivered in multiple ways. Future work Prior to future commissioning decisions, further research to enhance the evidence base could help address the urgent need for effective strategies. Testing individual procedures, for example, audit and feedback, could ascertain which are the most effective intervention components. Separate testing of individual components could improve understanding of content and delivery. Study registration The study is registered as PROSPERO CRD42018086985. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 5. See the NIHR Journals Library website for further project information.

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“…All participants identified the need for knowledge about the effectiveness of modalities set up in the SMRs and to have this knowledge effectively transferred to end- users (both service users and health providers). The translation of SMR evidence into practice has also been highlighted by others [14, 39], with emphasis on the need to carefully consider the dynamic nature of the clinical setting in which the SMR is to implemented. Based on these results, early coordinated educational and organizational efforts are needed to optimize the value added by this evidence-based intervention in this setting.…”

Section: Discussionmentioning

confidence: 99%

Health provider and service-user experiences of sensory modulation rooms in an acute inpatient psychiatry setting

et al. 2019

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BackgroundSensory modulation rooms (SMRs) are therapeutic spaces that use sensory modulation concepts and strategies to assist service users to self-regulate and modulate arousal levels. SMRs are increasingly being explored as strength-based and person-centered adjuncts to care for people receiving inpatient psychiatry services. The aim of this study is to understand health provider and inpatient service user perceptions on the use of SMRs on acute psychiatric units.MethodsWe conducted semi-structured interviews with ten service users and nine health providers (four occupational therapists and five nurses) regarding their experiences of the SMRs located on three acute inpatient units in a large urban tertiary care hospital. We audio recorded and transcribed the focus groups and used thematic analysis to analyze the data.ResultsOur results suggested four common themes amongst health provider and service user experiences of sensory modulation rooms: (1) service user empowerment through self-management, (2) emotional regulation, (3) an alternative to current practices, and (4) health provider and service user education.ConclusionOur study supports the ecological utility of SMRs as person-centred adjunct therapeutic space viewed positively by both service users and health providers. This understanding of SMRs is critical for future service design, research and policy aimed at improving the service user experience and care for this population. Future research is needed to validate the experience of the SMRs with other patient groups and health providers.

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Sensory modulation and trauma-informed-care knowledge transfer and translation in mental health services in Victoria: Evaluation of a statewide train-the-trainer intervention

Cited by 19 publications

References 30 publications

Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives

Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives

Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review

Health provider and service-user experiences of sensory modulation rooms in an acute inpatient psychiatry setting

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