Cowman Seamus, Bowers Len
Royal College of Surgeons in Ireland, Dublin, Republic of Ireland.
J Clin Nurs. 2009 May;18(9):1346-53. doi: 10.1111/j.1365-2702.2008.02601.x. Epub 2008 Dec 11.
The comparative element of this study is to describe safety and security measures in psychiatric acute admission wards in the Republic of Ireland and London; to describe differences and similarities in terms of safety and security patterns in the Republic of Ireland and London; and to make recommendations on safety and security to mental health services management and psychiatric nurses.
Violence is a serious problem in psychiatric services and staff experience significant psychological reactions to being assaulted. Health and Safety Authorities in the UK and Ireland have expressed concern about violence and assault in healthcare, however, there remains a lack of clarity on matters of procedure and policy pertaining to safety and security in psychiatric hospitals.
A descriptive survey research design was employed.
Questionnaires were circulated to all acute wards in London and in Ireland and the resulting data compared.
A total of 124 psychiatric wards from London and 43 wards from Ireland were included in this study and response rates of 70% (London) and 86% (Ireland) were obtained. Differences and similarities in safety and security practices were identified between London and Ireland, with Irish wards having generally higher and more intensive levels of security.
There is a lack of coherent policy and procedure in safety and security measures across psychiatric acute admission wards in the Republic of Ireland and London. Given the trends in European Union (EU) regulation, there is a strong argument for the publication of acceptable minimum guidelines for safety and security in mental health services across the EU.
There must be a concerted effort to ensure that all policy and procedure in safety and security is founded on evidence and best practice. Mental health managers must establish a review of work safety and security procedures and practices. Risk assessment and environmental audits of all mental health clinical environments should be mandatory.
本研究的比较内容在于描述爱尔兰共和国和伦敦的精神科急性入院病房的安全保障措施；阐述爱尔兰共和国和伦敦在安全保障模式方面的异同；并就安全保障问题向心理健康服务管理部门和精神科护士提出建议。
暴力行为是精神科服务中的一个严重问题，工作人员在遭受攻击后会经历重大的心理反应。英国和爱尔兰的健康与安全当局已对医疗保健中的暴力和攻击行为表示关注，然而，在精神病医院安全保障的程序和政策问题上仍缺乏明确性。
采用描述性调查研究设计。
向伦敦和爱尔兰的所有急性病房发放问卷，并对所得数据进行比较。
本研究纳入了来自伦敦的124个精神科病房和来自爱尔兰的43个病房，伦敦的回应率为70%，爱尔兰为86%。确定了伦敦和爱尔兰在安全保障措施方面的异同，爱尔兰病房的安全保障水平总体上更高且更严格。
爱尔兰共和国和伦敦的精神科急性入院病房在安全保障措施方面缺乏连贯的政策和程序。鉴于欧盟法规的趋势，强烈主张在整个欧盟公布心理健康服务中可接受的最低安全保障指南。
必须共同努力确保所有安全保障政策和程序都基于证据和最佳实践。心理健康管理人员必须对工作安全保障程序和做法进行审查。应对所有心理健康临床环境进行风险评估和环境审计，这应成为强制性要求。
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