[Long Term Evaluation of the Implementation of the Safewards Model - Results of a Follow-Up-Study Among Patients and Staff in Acute Psychiatric Wards]. / Langzeitevaluation der Implementierung des Safewards-Modells ­ Ergebnisse einer Follow-Up-Erhebung unter Patient*innen und Mitarbeitenden der Akutpsychiatrie.

OBJECTIVE: Evaluation of long-term effects of the implementation of the Safewards Model (SM) among staff and patients in acute psychiatry in Germany. METHOD: Assessment of ward atmosphere, job satisfaction, fidelity, and coercive interventions in 2 locked wards directly before and 15 months after implementation of the SM. RESULTS: Ward atmosphere was assessed significantly better after implementation, job satisfaction was still above-average at both times, coercive interventions declined significantly in one ward, fidelity and degree of implementation were still high. CONCLUSIONS: The implementing of the SM in locked wards in acute psychiatry can also have positive effects in long run.

Corrigendum: Preventing and Reducing Coercive Measures-An Evaluation of the Implementation of the Safewards Model in Two Locked Wards in Germany.

[This corrects the article DOI: 10.3389/fpsyt.2019.00340.].

[Changes on Ward Atmosphere and Job Satisfaction after Implementation of the Safewards Model in Two Locked Acute Psychiatric Wards - A Multi-Perspective Evaluation]. / Veränderungen des Stationsklimas und der Arbeitszufriedenheit nach Einführung des Safewards-Modells auf zwei geschützten akutpsychiatrischen Stationen ­ Eine multiperspektivische Evaluation.

OBJECTIVE: Evaluation of the changes of ward atmosphere and job satisfaction after the implementation of the Safewards model in acute psychiatry in Germany. METHOD: A multi-perspective pre-post study design was conducted in two locked wards among patients (n = 80) and staff (n = 88) before and after the implementation of the Safewards model over a period of 12 months. RESULTS: After the implementation of the Safewards model, ward atmosphere and job satisfaction improved. Both correlated positively amongst staff. Furthermore, job satisfaction correlated positively with a high degree of implementation of two interventions. Fidelity to the Safewards model was high. CONCLUSIONS: Implementing the Safewards model in acute psychiatry with high fidelity can have positive effects on positive ward atmosphere and job satisfaction. Thus, patients as well as staff benefit from this model. With regards to high fluctuation in acute psychiatry, the implementation of the Safewards model can additionally facilitate retention management.

Preventing and Reducing Coercive Measures-An Evaluation of the Implementation of the Safewards Model in Two Locked Wards in Germany.

Introduction: Aggression and violence are highly complex problems in acute psychiatry that often lead to the coercive interventions. The Safewards Model is an evidence-informed conflict-reduction strategy to prevent and reduce such incidents. The aim of this study was to evaluate the implementation of this model with regard to coercive interventions in inpatient care. Materials and Methods: We evaluated outcomes of the implementation of the Safewards Model in two locked psychiatric wards in Germany. Frequency and duration of coercive interventions applied during a period of 10 weeks before and 10 weeks after the implementation period were assessed through routine data. Fidelity to the Safewards Model was assessed by the Organization Fidelity Checklist. Results: Fidelity to the Safewards Model was high in both wards. The overall use of coercive measures differed significantly between wards [case-wise: χ2 (1, n = 250) = 35.34, p ≤ 0.001; patient-wise: χ2 (1, n = 103) = 21.45, p ≤ 0.001] and decreased post-implementation. In one ward, the number of patients exposed to coercive interventions in relation to the overall number of admissions decreased significantly [χ2 (1, 182) = 9.30, p = 0.003]. Furthermore, the mean duration of coercive interventions overall declined significantly [U(55,21) = -2.142, p = 0.032] with an effect size of Cohen's d = -0.282 (95% CI: -0.787, 0.222) in that ward. Both aspects declined as well in the other ward, but not significantly. Discussion: Results indicate that the implementation of the Safewards interventions according to the model in acute psychiatric care can reduce coercive measures. They also show the role of enabling factors as well as of obstacles for the implementation process.