The Safewards Model and Cluster RCT

Location: Room BG03, Northampton Square, City University London, EC1V 0HB

Professor Len Bowers is a leading mental health nursing researcher and will be presenting the results from a study that has important implications for mental health nursing care in acute psychiatric settings. A cluster RCT of a complex intervention based on the Safewards Model has recently been completed. This large study involved thirty wards at fifteen hospitals and Safewards led to significant decreases in conflict and containment in the experimental group of wards. The model, the interventions, the results and what to do next will be presented and discussed at this lecture.

Conflict (aggression, self-harm, suicide, absconding, substance/alcohol use and medication refusal) and containment (as required medication, coerced intramuscular medication, seclusion, manual restraint, special observation) place patients and staff at risk of serious harm. The frequency of these events varies between wards, but there are few explanations as to why this is so, and a coherent model is lacking. The Safewards Model provides a comprehensive explanation of these differences.

During this lecture the Model will be described with its evidence base. There are significant implications for methods for reducing risk and coercion on inpatient wards. The model depicts six domains of originating factors, giving rise to flashpoints that have the capacity to trigger conflict and/or containment. Staff interventions can modify these processes.

Professor Len Bowers is a qualified psychiatric nurse with clinical and managerial experience in acute inpatient and community care. His doctoral thesis was published as a book, The Social Nature of Mental Illness, and a second book about positive attitudes to personality disordered people is influential and widely read.

Len was a professor at City University London where he commenced a program of research into inpatient care, and ways to reduce conflict and containment. He now leads a team of researchers investigating this issue at the Institute of Psychiatry, has completed more than £4 million of grant funded research, and has authored over a hundred peer reviewed publications. Len has advised the UK government on policy issues and contributed to policy guidelines on psychiatric nursing practice.

For further information about this seminar please contact Chris Flood.