McKeown, M, Thomson, G, Scholes, A et al. (7 more authors) (2019) “Catching your tail and firefighting”: The impact of staffing levels on restraint minimization efforts. Journal of Psychiatric and Mental Health Nursing, 26 (5-6). pp. 131-141. ISSN 1351-0126
Abstract
1 Introduction
Safe staffing and coercive practices are of pressing concern for mental health services. These are inter‐dependent, and the relationship is under‐researched.
2 Aim
To explore views on staffing levels in a context of attempting to minimize physical restraint practices on mental health wards. Findings emerged from a wider data set with the broader aim of exploring experiences of a restraint reduction initiative.
3 Methods
Thematic analysis of semi‐structured interviews with staff (n = 130) and service users (n = 32).
4 Results
Five themes were identified regarding how staffing levels impact experiences and complicate efforts to minimize physical restraint. We titled the themes—“insufficient staff to do the job”; “detriment to staff and service users”; “a paperwork exercise: the burden of non‐clinical tasks”; “false economies”; and, “you can't do these interventions.”
5 Discussion
Tendencies detracting from relational aspects of care are not independent of insufficiencies in staffing. The relational, communicative and organizational developments that would enable reductions in use of restraint are labour intensive and vulnerable to derailment by insufficient and poorly skilled staff.
6 Implications for practice
Restrictive practices are unlikely to be minimized unless wards are adequately staffed. Inadequate staffing is not independent of restrictive practices and reduces access to alternative interventions for reducing individuals’ distress.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 John Wiley & Sons Ltd. This is the post-peer reviewed version of the following article: McKeown, M, Thomson, G, Scholes, A, et al. “Catching your tail and firefighting”: The impact of staffing levels on restraint minimization efforts. J Psychiatr Ment Health Nurs. 2019; 26: 131– 141, which has been published in final form at https://doi.org/10.1111/jpm.12532. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Keywords: | acute care; physical restraint; qualitative methodology; staffing/resources |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Mental Health (Leeds) |
Funding Information: | Funder Grant number Health Foundation 7263 |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 May 2019 09:32 |
Last Modified: | 20 May 2020 00:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/jpm.12532 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:146243 |