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Safety and security procedures in psychiatric acute admission wards

Royal College of Surgeons in Ireland, Dublin

Jim Walsh, MSc, RGN, RPN, RNT

Centre for Education, Tallagh Hospital, Dublin, Ireland

Violence and assaultive behaviour is a serious and growing problem in psychiatric services across the world. Despite many concerns about violence and assault in healthcare, there is an alarming lack of clarity on matters of procedure and policy pertaining to safety and security in psychiatric hospitals.

This paper describes the safety and security measures in psychiatric acute admission wards in the Republic of Ireland and may be considered to be representative of acute psychiatric settings in other jurisdictions. A population study was undertaken, which included all psychiatric acute admission wards in the Republic. A descriptive survey research design was adopted, with the use of a questionnaire for data collection. The questionnaire was analysed using SPSS (version 11) and descriptive statistics were used to present the results.

There was wide variation in safety and security practices across the wards. Measures aimed at ensuring staff security were also lacking, with no overall acceptable minimal standards discernible. It may be concluded that there is a lack of coherent policy and procedure in safety and security measures across psychiatric acute admission wards. One has to ask to what extent the disparate practices in safety and security revealed in the results of the study account for the escalation in violent episodes and assaultive behaviour in psychiatric services in recent years.

Key Words: Psychiatric • Safety • Security • Assault • Violence • Locked doors

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