title: Ward safety perceived by ward managers in Britain, Germany and Switzerland: identifying factors that improve ability to deal with violence.
abstract: Little is known about how safe nurses feel on psychiatric wards across different European countries. This paper is aim to evaluate how ward safety is perceived by ward managers in Great Britain, Germany and Switzerland. We replicated a Swiss questionnaire study in Germany and Britain, which asked ward managers on adult psychiatric wards to give details about their ward including data on the management of aggression, staffing levels, staff training, standards and type of restraint used, alarm devices, treatment and management of aggression and the existence and perceived efficacy of standards (protocols, guidelines). The British sample had by far the highest staffing levels per psychiatric bed, followed by Switzerland and Germany. The British ward managers by far perceived violence and aggression least as a problem on their wards, followed by Germany and then Switzerland. British ward managers are most satisfied with risk management and current practice dealing with violence. German managers were most likely to use fixation and most likely to have specific documentation for coercive measures. Swiss wards were most likely to use non-specific bedrooms for seclusion and carry alarm devices. British wards were far more likely to have protocols and training for the treatment and management of violence, followed by Switzerland and Germany. British ward managers by far perceived violence and aggression to be a small problem on their wards compared with Swiss and German ward managers. This was associated with the availability of control and restraint teams, regular training, clear protocols and a lesser degree risk assessments, but not staffing levels.
authors.affiliation: Wrexham Academic Unit, Technology Park, Wrexham LL13 7YP, Wales, UK. peter.lepping@wales.nhs.uk
authors.forename: P
authors.initials: P
authors.lastname: Lepping
authors.forename: T
authors.initials: T
authors.lastname: Steinert
authors.forename: I
authors.initials: I
authors.lastname: Needham
authors.forename: C
authors.initials: C
authors.lastname: Abderhalden
authors.forename: E
authors.initials: E
authors.lastname: Flammer
authors.forename: P
authors.initials: P
authors.lastname: Schmid
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel / Q000208:ethnology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D009718:Nurse Administrators / Q000458:organization & administration / Q000523:psychology*; D015404:Nursing Methodology Research; D010356:Patient Isolation; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011568:Psychiatric Nursing / Q000193:education / Q000458:organization & administration*; D012149:Restraint, Physical; D018570:Risk Assessment; D017751:Safety Management / Q000458:organization & administration*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data