best practices rondom dwangreductie in de geestelijke ...

inhoudsopgave
1 achtergronden ................................................................................................................................................................................................................................................ 4
1.1 Aanleiding onderzoek ................................................................................................................................................................................................................ 4
1.2 Doel- en vraagstelling ............................................................................................................................................................................................................... 4
1.3 Onderzoeksopzet .............................................................................................................................................................................................................................. 4
1.4 Leeswijzer .................................................................................................................................................................................................................................................. 5
2 theoretisch kader ..................................................................................................................................................................................................................................... 6
2.1 Best Practices ....................................................................................................................................................................................................................................... 6
2.1.1 Definitie .................................................................................................................................................................................................................................... 6
2.1.2 Overdracht van best practices ................................................................................................................................................................... 6
2.2 Dwangreductie: een systeemtransitie ................................................................................................................................................................. 7
3 Best Practices ................................................................................................................................................................................................................................................... 8
3.1 Bejegening & contact ................................................................................................................................................................................................................ 8
3.2 Preventief werken & risicotaxatie ............................................................................................................................................................................ 12
3.3 De-escalerend werken .............................................................................................................................................................................................................. 17
3.4 Evaluatie ...................................................................................................................................................................................................................................................... 20
3.5 Reflectie ........................................................................................................................................................................................................................................................ 22
3.6 Samenwerking & consultatie .......................................................................................................................................................................................... 24
3.7 Participatie van cliënten ....................................................................................................................................................................................................... 27
3.8 Participatie van naastbetrokkenen ......................................................................................................................................................................... 28
3.9 Registratie ................................................................................................................................................................................................................................................. 30
3.10 Intensive Care ...................................................................................................................................................................................................................................... 31
3.11 Samenwerking met de ambulante zorg ........................................................................................................................................................... 34
3.12 Tot slot ........................................................................................................................................................................................................................................................... 36
4 als escalatie niet voorkomen kan worden ............................................................................................................................................... 38
5 knelpunten ............................................................................................................................................................................................................................................................ 41
5.1 Samenwerking ..................................................................................................................................................................................................................................... 41
5.2 Leiderschap & aansturing .................................................................................................................................................................................................... 41
5.3 Dwang en drang, de zorg van de kliniek? ..................................................................................................................................................... 42
5.4 Meten is weten? ............................................................................................................................................................................................................................... 42
5.5 Bezuinigingen ...................................................................................................................................................................................................................................... 42
6 conclusies en aanbevelingen ............................................................................................................................................................................................ 43
6.1 Conclusies .................................................................................................................................................................................................................................................. 43
6.2 Aanbevelingen ..................................................................................................................................................................................................................................... 44
literatuur .................................................................................................................................................................................................................................................................. 45
Bijlagen ........................................................................................................................................................................................................................................................................ 48
dankwoord ............................................................................................................................................................................................................................................................ 52
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