ArticleInternational journal of mental health nursing2020
Safewards: Changes in conflict, containment, and violence prevention climate during implementation.
Article in International journal of mental health nursing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 40 citations in OpenAlex.
- Perspectives and Experiences of People Receiving Care on a De-escalation Intervention to Reduce Restrictive Practices in Acute Mental Health Units.International journal of mental health nursing · 2026Article
- Eliminating Seclusion Use for Women in Secure Forensic Hospitals. Are We Doing Enough to Consider Sex and Gender Differences for Elimination?International journal of mental health nursing · 2026Article
- Exploring the Impact of Safewards on Aggression and Coercion in Psychiatric Inpatient Care: Findings From a Swedish Longitudinal Quasi-Experimental Trial.International journal of mental health nursing · 2026Article
- Putting Lived Experience at the Centre: A Critical Review of Multidisciplinary, Person-Centred Mental Health Care.Journal of multidisciplinary healthcare · 2026Review
- Differentiating Therapeutic Responses That Reduce Restrictive Practice Use and Situational Aggression in an Acute Mental Health Unit.Journal of clinical nursing · 2025Article
- Psychiatrists' experiences with the implementation of safewards and other quality improvement work: an explorative, qualitative interview study.BMC psychiatry · 2025Article
- Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before-and-After Study.International journal of mental health nursing · 2025Article
- Understanding the Consumers' Experiences of Safewards: A Qualitative Exploratory Study.International journal of mental health nursing · 2025Article
- Maximising relational capabilities and minimising restrictive practices in acute mental health units: the Safe Steps for De-escalation evaluation.Frontiers in psychiatry · 2025Article
- Evaluating the Safe Steps for De-escalation: A protocol for a mixed concurrent control study in acute mental health units.PloS one · 2025Article
- Patient responsiveness as a safewards fidelity indicator: a qualitative interview study on an acute psychiatric in-patient ward.BMC health services research · 2024Article
- SafeVRwards: Designing a complementary virtual reality module to the Safewards framework intended to relax and manage conflict in mental health wards.BMJ open quality · 2024Article
- Reducing violence and aggression: a quality improvement project for safety on an acute mental health ward.BMJ open quality · 2023Article
- Sustaining a therapeutic environment within mental health in-patient settings during COVID-19. Results of a Delphi study.Applied nursing research : ANR · 2023Review
- Safewards: An integrative review of the literature within inpatient and forensic mental health units.International journal of mental health nursing · 2022Review
- Mental health nurses' experience of challenging workplace situations: A qualitative descriptive study.International journal of mental health nursing · 2022Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
Abstract
Since its development, there has been growing utilization of the Safewards package of interventions to reduce conflict and containment in acute mental health wards. The current study used the opportunity of an implementation of Safewards across one large metropolitan local health district in New South Wales Australia to evaluate change. Specific aims of the study were to measure, for the first time in Australia, changes in shift-level reports of conflict and containment associated with Safewards introduction, and to measure any association with change in the violence prevention climate using a tool validated for use in the current study setting. Eight of eleven wards opted-in to participating in Safewards. Implementation was conducted over a period of 24 weeks (4-week preparation, 16-week implementation, and 4-week outcome phases). Conflict and containment were measured using the Patient-Staff Conflict Checklist Shift Report and violence prevention climate using the VPC-14. From 63.2% response rate, the mean (SD) reported conflict and containment incidents per shift fell from 3.96 (6.25) and 6.81 (5.78) to 2.94 (4.22) and 5.82 (4.62), respectively. Controlling for other variables, this represented reductions of 23.0 and 12.0%, respectively. Violence prevention climate ratings did not change. Safewards was associated with significant improvements in all incidents of conflict and containment, including the most severe and restrictive types, and this was largely unaffected by outcomes measure response rate, shift or weekday/weekend reporting, or number of ward beds. Safewards is increasingly justified as one of very few interventions of choice in adult, acute mental health services and should be widely utilized.
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