Evaluation of the Implementation of the Safewards Model in an Open-Door Acute Inpatient Unit: A quasi-experimental study

Background Safewards is a multi-intervention mental health nursing model evidence-based practice, aimed at preventing and reducing conflict and containment.

Objective To evaluate the effectiveness of the implementation of Safewards model in an open-door acute mental health unit. This analysis examines the impact of the Safewards model on conflict levels and restrictive therapeutic measures.

Design A prospective quasi-experimental study was conducted between August 2019 and January 2022, with patients admitted to an acute mental health unit from Spain.

Methods Descriptive and inferential analysis will be conducted. Multivariate regression models will be used to investigate the relationship between coercive measures, conflict levels, and clinical and demographic variables, adjusting for covariates if necessary.

Results The results indicated statistically significant differences in several variables such as rule violations (F=6.11, df= 1, p < .014), verbal aggression (F=14.9, df = 1, p < .001), and physical aggression towards objects (F = 7.2, df= 1, p < .008).

The results indicated a statistically significant differences in restrictive therapeutic measures: intramuscular forced medication (F=8.5, df= 1, p < .004), environmental seclusion (F=14.6, df = 1, p < .001), and verbal/behavioural containment (F=75.0, df = 1, p < .001).

Conclusion This is the first study to evaluate the implementation of the Safewards model in an open-door acute inpatient unit in Spain with respect to restrictive therapeutic measures.