RecruitingACTRN12624000044527

Implementation of Safewards to manage the use of restrictive practices in residential aged care

Evaluating the effectiveness and feasibility of Safewards in managing restrictive practices for people with dementia and other complex needs in residential aged care.

Sponsor

Uniting Communities Incorporated

Enrollment

200 participants

Start Date

Oct 27, 2023

Study Type

Interventional

Conditions

Dementia Responsive behaviours

Summary

Safewards is a model that was developed in the United Kingdom for use in mental health inpatient services. The model is based on training staff, and giving staff the resources, to implement 10 psycho-social interventions that allow staff to reduce resident distress, agitation and anger. By doing so, the interventions reduce escalation of conflict between staff and residents, and in reducing conflict, there is a reduction in the use of restrictive practices, such as the use of physical restraint. The study we are undertaking is testing if the Safewards model is effective in residential aged care.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

Safewards is a model originally developed for mental health hospital wards in the UK that trains staff to use ten practical, evidence-based strategies for reducing conflict and distress among patients. By improving how staff and residents interact, these approaches aim to reduce the need for restrictive practices — such as physical restraint — that can be distressing and harmful. This study is testing whether the Safewards model can be successfully adapted and implemented in residential aged care facilities in Australia. The trial involves training aged care staff at participating facilities and giving them the tools and resources to implement the ten Safewards interventions in their daily work. Researchers will measure whether staff feel more confident and equipped, and whether the use of restrictive practices decreases as a result. The study is primarily focused on staff outcomes and practice change, rather than enrolling residents directly. This study is open to aged care staff, including carers, nurses, and organisational leaders, working at facilities participating in the trial. Participation is entirely voluntary and there are no formal exclusion criteria. If you work in an aged care facility taking part in this study, you may be invited to complete surveys or participate in training and interviews.

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Interventions

Aged care staff from a range of disciplinary backgrounds will be trained in the Safewards interventions. Safewards interventions include: clear mutual expectations, soft words, positive words, talk down, bad news mitigation, knowing each other, calm down methods, reassurance, discharge messages, mutual help meetings. The clinical educator from the aged care organisation and two trainers from the project team (one staff with lived experience and one mental health clinician) will provide on-site training of aged care staff. Training will be conducted face to face or via Teams and will consist of 12 minute sessions. Staff will be invited to attend training sessions for each intervention. Implementation of each intervention will occur concurrently with training over 12 weeks. We are aiming to train 50% of staff from each site in each intervention. Attendance will be monitored via a records sheet. An on-line community of practice group between sites will be established to share learnings and support implementation across sites. Posters about Safewards will inform residents and families of the project. Letters will be sent to families informing them of Safewards. Families and residents will be invited to participate in relevant interventions e.g., know each other, meaningful messages.