Working towards least restrictive environments in acute mental health wards in the context of locked door policy and practice

Fletcher, Justine; Hamilton, Bridget; Kinner, Stuart A; Sutherland, Georgina; King, Kylie; Tellez, Juan José; Harvey, Carol; Brophy, Lisa

doi:10.1111/inm.12559

Cited by 25 publications

(53 citation statements)

References 37 publications

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“…The safety of the physical environment category included 21 papers (6%). Seven studies investigated security measures (eg, door locking) 319–325. Five studies investigated the effects of the physical environmental design on the safety of treatment settings 326–330.…”

Section: Resultsmentioning

confidence: 99%

Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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ObjectivesPatients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.DesignSystematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.ResultsOf the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.ConclusionsPatient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration numberCRD42016034057.

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Section: Resultsmentioning

confidence: 99%

Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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“…Service providers should view the checklist as part of an overall suite of measures aimed at reducing absconding, as recently described by Fletcher et al . ().…”

Section: Discussionmentioning

confidence: 97%

“…; Fletcher et al . ). While the locking of acute units may prevent patients from ‘walking out’ of open units, failure to return from approved leave continues to present a significant problem (Bailey et al .…”

Section: Introductionmentioning

confidence: 97%

Development of a checklist to aid in the assessment of ‘failure to return’ from approved leave by acute inpatients

Meehan

Mansfield

Stedman

2019

Int J Mental Health Nurs

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Better assessment of consumer behaviour and intentions prior to the granting of approved leave may reduce failure to return from such episodes of leave. The aims of this study were (i) to gain consensus on the factors associated with failure to return, and (ii) use these factors to construct a checklist to aid in assessment of consumers prior to being granted leave. Following a review of the literature a pool of 36 factors was identified. These were then assessed for relevance to absconding from approved leave using a modified Delphi approach. After two Delphi rounds, 10 factors were retained and these were collapsed under 6 domains; history of absconding, current substance use, behaviour cues, verbal cues, lack of engagement, and changes in mental state. While staff reactions to the checklist were positive, further testing of its effectiveness in the clinical setting is required.KEY WORDS: acute ward, checklist, failure to return, leave, risk assessment.

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“…Nevertheless, in this situation, users may have low motivations due to the restriction of parking areas, which might change their original habit of parking bicycles at will. As reported by Warner [51], the stakeholder with the lowest participation positivity will always destruct the governance achievements during the process of public problems [52,53]. Thus, the main point for the implementation of the governance effect is the normalization of user parking behavior.…”

Section: Tripartite Collaborative Governance Modelmentioning

confidence: 95%

The Research of Tripartite Collaborative Governance on Disorderly Parking of Shared Bicycles Based on the Theory of Planned Behavior and Motivation Theories—A Case of Beijing, China

Zhao

Wang

2019

Sustainability

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With the maturity of mobile payments and internet technology, a new type of travel mode, shared bicycles, was brought out by China’s urban transport under the impetus of “the last mile” travel demand. Although convenient travel has been achieved by using shared bicycles, the resulting problems such as disorderly parking and the deposition of bicycles could severely influence urban traffic order and impede the sustainable development of shared bicycles. Based on the quasi-public goods property of shared bicycles, this article established a management system for the tripartite collaborative governance of disorderly bicycle parking by virtue of regulating the bicycle parking behavior of users, the promoting of multiple propaganda and macro-institutional controls of the government, and acquiring technique support of enterprise “entry settlement”. Furthermore, considering the influence on the governance effect of user conduct, a structural model for guiding users to regulate bicycle parking to guarantee the governance effect by adopting material incentive and spiritual motivation was established via the utilization of the theory of planned behavior and motivation theories, and multiple hypotheses were also proposed. In this article, users of shared bikes in Beijing, China were selected as the research objects, and a questionnaire survey was adopted as the empirical research method. In addition, the governance validity on disorderly parking of the collaborative governance model was tested via hierarchical regression analysis after the collection and analysis of the factors influencing bicycle parking behavior of users. The obtained results show that the tripartite collaborative governance model could enhance the regular parking consciousness of users and improve the governance effect of disorderly parking. The research conclusion of this article could provide feasible suggestions for the governance of bicycle disorderly parking and propel the sustainable development of shared bicycles.

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Working towards least restrictive environments in acute mental health wards in the context of locked door policy and practice

Cited by 25 publications

References 37 publications

Patient safety in inpatient mental health settings: a systematic review

Patient safety in inpatient mental health settings: a systematic review

Development of a checklist to aid in the assessment of ‘failure to return’ from approved leave by acute inpatients

The Research of Tripartite Collaborative Governance on Disorderly Parking of Shared Bicycles Based on the Theory of Planned Behavior and Motivation Theories—A Case of Beijing, China

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