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Safewards is a model explaining variation in conflicts and containment. This model primarily aims in reducing conflict in Mental health care practices especially between the patient and heat care service providers. Safewards is a clinical model which ensures that mental health care practices are safer and less coercive in nature. This model was developed in UK and it went through various clinical trials and studies before it was implemented by other health care systems. It has been proved to be a very effective model of safe practice which has brought down incidence of conflicts and confrontation in mental health care practice to a lower level. This report would be focusing on the fitness of this model with the philosophy of recovery, least restrictive practices and implications on the practice of a mental health nurse (Price, et al. 2016).
Body of Essay
Conflicts and containment is not a new phenomenon in mental health practices. Aggression, self harm, suicide, absconding are some of the common form of conflicts and medication, coerced intramuscular medication, seclusion and manual restraints are some of the commonly found containment practices in mental health care. Frequency of such incidence does vary from hospital to hospital and wards but it is a fact that such incidence do occur. It has been found through various research based evidence that conflicts and containment act as a hindrance in recovery of patient, delay their prognosis and also enhance resource consumption of the hospitals. Safewards as a model aims to reduce these incidents and enhances effectiveness of mental health practices and also safeguards the interest of patients, families and hospitals simultaneously (Paton, et al. 2016).
It is a model with six different domains of originating factors namely the staff team, physical environment, patient community, patient characteristic, regulatory framework and outside hospital. All these domains have flashpoints which if triggered can reach to a conflict or containment. By practicing safewards model staff can reduce these flashpoints and make an early intervention before these flashpoints are triggered. Below is a graphic representation of safeward model of mental health practice which provides a brief idea about its applicability in different situations (Bowers, 2014).
Philosophy of recovery in mental health practices suggest that each patient has a potential of recovery and the treatment approaches should engage and emphasis on the potential. Some of the components of recovery philosophy are hope, secure base, supportive relationships and empowerment and inclusion. It is argued that if these components are positively enforced in a treatment plan there is a very higher probability of patient making a strong recovery from their ailment (Hiscox and Higgins, 2015).One of the staring differences between the philosophy of recovery in mental health and safeward model is the fact that safeward model is a very advanced and complex form of treatment approach which has multiple overlapping factors and interactive attributes. On the other hand philosophy of recovery is a relatively simple and linear form of approach which forms base of all mental health related treatment approaches. It can be said that safeward model is a refined and advanced form of philosophy of recovery and it is taking the treatment planning to the next level where incidences can be reduced (Alexander, et al. 2014).
Mental health nursing is a highly challenging job role which requires advanced level of skills for treatment planning and delivery. Models like Safeward require a mental health nurse to properly understand its domain and implications and then integrate it into their day to day practice.A nurse has to deal with many patients. All patients have different problems and behaviour (Mustafa, 2015).She should know how to cope up with each patient so that she can handle them. One of the first impacts on the practice of a mental health nurse due to safeward model is that she suddenly becomes aware of other stakeholders in the treatment plan, external and internal factors which can trigger the adverse reaction and the role played by each domain. This improvises their treatment planning and execution because these attributes and now considered and incorporated beforehand. First domain out of the 6 domains identified in the model is “staff team domain” which will have an impact on the least restrictive practices of a mental health nurse (Bowers, 2016). A mental health nurse would be more aware of their trigger points and flash points and they would understand up to what level they can control their own emotions and frustration and do not lead that to impact the treatment quality. A nurse should be happy and stable mentally themselves to deal with their patients. Staff anxiety and frustration is a common occurrence but this model will help them identify its early signs and they can immediately modify their behaviour, seek an outlet or replacement before it impacts a patient or family (Leamy and Slade, 2011). This way safeward as a model is protecting mental health nurses from making mistakes in their practice and inadvertently triggering flashpoints where patients might indulge in a conflict and need containment as well. Physical environment domain is also making a direct impact on the mental health practices of a nurse. Now they are well aware of the impact of physical environment on the behaviour of patients. They would ensure that patients who are more prone to conflict and containment are always engaged in a secure and safe physical environment where they feel comfortable. A greater level of respect would be expressed towards patient and their families by the mental health nurses to ensure that there are no flashpoint triggers Cox, L., (Campbell and Dalton, 2016).
In conclusion it can be said that Safeward is a very effective and efficient model which can improvise the quality of mental health care nursing and also it would increase the scope of mental health treatment. There are various taboos associated with mental health issues and their treatment in society which can be diluted by using safeward model which brings all stakeholders of a patient closer. The key challenge here is the proper execution of a safeward model because it is a complex model which requires a strong detailing and understanding among all mental health care service providers (Dart, et al. 2015).
Bowers, L., 2014. Safewards: a new model of conflict and containment on psychiatric wards. Journal of psychiatric and mental health nursing, 21(6), pp.499-508.
Alexander, J., Bilgin, H., Botha, M., Dack, C., James, K., Jarrett, M., Jeffery, D., Nijman, H., Owiti, J.A. and Papadopoulos, C., Bowers, L., 2014. Safewards: the empirical basis of the model and a critical appraisal. Journal of psychiatric and mental health nursing, 21(4), pp.354-364.
Paton, F., Wright, K., Ayre, N., Dare, C., Johnson, S., Lloyd-Evans, B., Simpson, A., Webber, M. and Meader, N., 2016. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care. Health Technologyl Assessment, 20(3).
Cox, L., Campbell, C. and Dalton, J., 2016. Teaching the safewards model in a bachelor of nursing program. Australian Nursing and Midwifery Journal, 23(11), p.49.
Leamy, M., Bird, V., Le Boutillier, C., Williams, J. and Slade, M., 2011. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), pp.445-452.
Mustafa, F.A., 2015. The Safewards study lacks rigour despite its randomised design. International journal of nursing studies, 52(12), pp.1906-1907.
Bowers, L., 2016. Response to Mustafa 2015: The Safewards study lacks rigour despite its randomised design. International journal of nursing studies, 53, pp.405-406.
Price, O., Burbery, P., Leonard, S.J. and Doyle, M., 2016. Evaluation of safewards in forensic mental health: Analysis of a multicomponent intervention intended to reduce levels of conflict and containment in inpatient mental health settings. Mental Health Practice, 19(8), pp.14-21.
Hiscox, C. and Higgins, N., 2015. Embracing Safewards–Our experiences from the ward. International Journal of Mental Health Nursing, 24, pp.23-24.
Dart, N., Fawcett, L., Kilshaw, M. and Meehan, T., 2015. Safewards Queensland: Back to the future!!. International Journal of Mental Health Nursing, 24, p.13.