SafeWards

SafeWards model

SafeWards is a nursing care model on psychiatric units, designed to reduce restraints, seclusions, and other containment strategies. 

SafeWards consists of 10 interventions described below:

1. Clear mutual expectations: guidelines for both service recipients and staff, which are not meant to feel like a child’s rules
2. Soft words: therapeutic limit setting designed with respect and negotiation in mind
3. Talk down: diffusion using words, not hands
4. Positive words: staff understand why difficult behavior occurs, and staff discuss positive things about each service recipient in shift reports to combat bad feelings about certain service recipients
5. Bad news mitigation: identifying service recipients who may have received bad news and allowing them to “vent” using active listening approaches
6. Know each other: staff and service recipients provide written information on themselves to use for conversation starters, kept in a binder in the unit for staff and service recipients to view.
7. Mutual help meeting: structured community meetings designed to help each other out with 5 sections, including thanks, news, suggestions, requests, and offers
8. Calm down methods: Before giving PRN medication, encourage the use of traditional coping strategies 
9. Reassurance: after an “incident”  (self-harm, aggression, restraint, seclusion, transfer to a more restrictive setting, etc.) in the unit, all service recipients are talked with to allow them to process the event 
10. Discharge messages: upon discharge, each service recipient writes a special card to be hung in a special place on the unit, about what they liked and disliked on the unit, the staff, and things that happened on the unit (without breaking confidentiality), to show to new service recipients to decrease hopelessness

The more we prioritize these interventions, the less conflict will be present, and as such, less upset, restraint, seclusion, and other containment strategies will be needed. 

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