The Relationship Between Patient-Staff Ratio and Reported Patient Incidents

Way, Bruce B.; Braff, Jeraldine; Hafemeister, Thomas L.; Banks, Steven M.

doi:10.1176/ps.43.4.361

Cited by 10 publications

(13 citation statements)

References 6 publications

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“…But there was even more from 13 to 15 o'clock, which was the time of nursing hand-over reports. This is in accordance with other studies (1,9,19,24) as is the finding that violence occurred hardly at all during night-time (13,25). This is due to the fact that patients are expected to sleep in order to follow the diurnal rhythm.…”

Section: Discussionsupporting

confidence: 93%

Violence in a Finnish forensic psychiatric hospital

Weizmann‐Henelius

2000

Nordic Journal of Psychiatry

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HJO. Violence in a Finnish forensic psychiatric hospital. Nord J Psychiatry 2000;54:269-273. Oslo. ISSN 0803-9488.A study of the number, perpetrator, time and target of violent behaviour was carried out in a Finnish state forensic psychiatric hospital, Vanha Vaasa Hospital -Gamla Vasa Sjukhus. Forensic psychiatric patients and patients difficult-to-treat are treated in the hospital. According to the results the number of violent incidents has been quite small in the hospital during the time of the study in relation to violence in similar units and hospitals. The patients treated on account of their dangerousness and difficult propensities were the most violent, not the patients who had been charged with their violent acts. Only a small number of the patients behaved violently in the hospital. The relative number of violent female patients was larger than that of the male patients. Trained nurses and the patients themselves were found to be more often the target of the violent behaviour of particularly violent patients, whereas less violent patients directed their aggressiveness against objects. Violent incidents were more frequent during nights and at the time of patients' activities, but especially during the change of working shifts. The fewest violent incidents occurred in autumn.• Forensic psychiatric hospital, Forensic psychiatric patients, Violence.

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Section: Discussionsupporting

confidence: 93%

Violence in a Finnish forensic psychiatric hospital

Weizmann‐Henelius

2000

Nordic Journal of Psychiatry

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“…This can contribute to a reliance on restrictive patient management procedures such as seclusion (Donat 2002). A low staff–patient ratio can lead to nurses being overworked, feeling demoralized and being unable to apply adequate interventions (Way et al . 1992).…”

Section: The Opportunities For Reducing Seclusion In a Forensic Hospitalmentioning

confidence: 99%

“…This can contribute to a reliance on restrictive patient management procedures such as seclusion (Donat 2002). A low staff-patient ratio can lead to nurses being overworked, feeling demoralized and being unable to apply adequate interventions (Way et al 1992). Research has shown that nurses in forensic hospitals can experience higher job satisfaction and lower burnout than mainstream colleagues (Happell et al 2003), but the contribution of a higher staff-patient ratio is unknown.…”

Section: Staff-patient Ratiomentioning

confidence: 99%

Seclusion reduction in a forensic mental health setting

Maguire¹,

Young²,

Martin

2011

Psychiatric Ment Health Nurs

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Seclusion has become a contentious practice and initiatives have commenced to reduce or eliminate its use. This paper presents the initiatives that were introduced during a seclusion reduction project that was undertaken at an Australian forensic hospital. These initiatives are based on the six core strategies that have been successfully used in North America to reduce seclusion. However, there are challenges (patient characteristics, prisoner culture and ensuring safety) and opportunities (longer admissions, higher staff-patient ratio, staff confidence, sound risk assessment and management) that can influence projects to reduce seclusion in a forensic hospital. During this project, the frequency (mainly multiple seclusions of patients) and duration of seclusion events were reduced but there was less reduction in the number of patients that were secluded. It is possible that the strategies were successfully supported by the identified opportunities to reduce the frequency and duration of seclusion but the challenges were significantly powerful in the early period of admission to prompt the need for seclusion. Reducing seclusion in a forensic hospital is a complex undertaking as nurses must provide a safe environment while dealing with volatile patients and may have little alternative at present but to use seclusion after exhausting other interventions.

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“…Although the literature about actual seclusion rates in relation to staffing level and shift has been inconclusive (Way et al . 1992, Fisher 1994, Morrison & Lehane 1995, Janssen et al .…”

Section: Discussionmentioning

confidence: 99%

“…2008). Facility factors such as census, shift and staffing level, have been extensively investigated with however contradictory results (Way et al . 1992, Fisher 1994, Morrison & Lehane 1995, Janssen et al .…”

Section: Introductionmentioning

confidence: 99%

Nurses' decision on seclusion: patient characteristics, contextual factors and reflexivity in teams

Boumans

Egger

Souren

et al. 2011

Psychiatric Ment Health Nurs

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While many characteristics of patients, professionals and facilities with relevance to seclusion rates have been investigated, their relative importance is unclear. Virtually no attention has been paid to team processes and reflexivity in relation to decision making on seclusion. The aim of this paper is to estimate the effects of these factors on nurse decision making on seclusion. Sixty Dutch psychiatric nurses of four closed wards reported team reflexivity and their tendency to seclude a theoretical patient. Approachability (whether there was a good or hardly any possibility to communicate with the patient), staffing level and confidence within the team had the greatest impact on the decision to seclude. Intra class correlation was 0.30. There was a large interaction effect of reflexivity with team 4, and team reflexivity was highly correlated with team tendency to avoid seclusion. In nurses' decision on seclusion, the effects of 'pure' patient characteristics are small as compared with the effects of interpersonal and contextual factors, and nurses vary widely in their judgement. Team reflexivity is related to the tendency to prevent seclusion.

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The Relationship Between Patient-Staff Ratio and Reported Patient Incidents

Cited by 10 publications

References 6 publications

Violence in a Finnish forensic psychiatric hospital

Violence in a Finnish forensic psychiatric hospital

Seclusion reduction in a forensic mental health setting

Nurses' decision on seclusion: patient characteristics, contextual factors and reflexivity in teams

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