Seattle University Collaborative Projects - International Academy of ...

Coercion Reduction: More than InterventionsY. Voskes (Y.voskes@vumc.nl)J. TheunissenG.A.M. WiddershovenBackground: Over the past 5 years many Dutch Mental Health trusts have developed initiativesto reduce coercive measures. Which initiatives show effect and which do not? What contributesto the effect? These questions were the main topics in an inventory of best practices in coercionreduction in the Netherlands. Goal: The aim of the study was to get an overview of seclusionreduction activities and understand which preconditions served successful implementation.Methods and Materials: 26 Mental Health Trusts which had organized seclusion reductionprograms for more than a year were visited. Interviews were held with key stakeholders and 2wards were visited. Team members were interviewed and team collaboration at the ward wasobserved. Before the visits documentation of the hospitals’ interventions, such as projectdescriptions and evaluation reports were studied. Results: We found 12 clusters of interventionsin the participating institutions: personal approach, prevention, de-escalation, incidentevaluation, reflection, collaboration, client participation, participation of next of kin, registration,intensive care, and collaboration with ambulatory care. Apart from these interventions structuralpreconditions (such as changes in physical environment and structural supportive activities) aswell as culture changes in team attitude and organisation were mentioned as relevant by theinterviewees. Conclusions: This study shows that implementing interventions alone is notsufficient in reducing coercion. Effective coercion reduction needs changes in work organisationas well as in the attitudes of teams. A change in working routines is only effective whenaccompanied by change in organisational structure and culture.Effects of Nursing Staff on Time in SeclusionW.A. Janssen, (Wim.Janssen@ggnet.nl)E.O. Noorthoorn,H.L.I. Nijman,A. Smit,C.L. MulderG.A.M. WiddershovenBackground: Recently in the Dutch Mental Health organisation, policy makers discussed flexibleplanning of personnel. This would allow more one to one or one to two patient supportpreventing the possibility of leaving a severely ill patient alone. Previous studies into personnelshow conflicting findings. Some show an increase in personnel leads to more seclusion, while337