Conflict behaviours (self-harm/suicidal crisis, medication-refusal, absconding, drug/alcohol misuse, rule-breaking, aggression/violence) Mental and Behavioural Disorders
Conditions
Interventions
A dedicated conflict de-escalation training package (EDITION) will be delivered for all ward staff in each of the ten wards to supplement existing NHS Prevention and Management of Violence and Aggress
Sponsors
University of Manchester
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: All patients with capacity to provide consent in the target settings and carers, mental health nurses, nursing assistants, occupational therapists, occupational therapy assistants, psychiatrists, clinical psychologists, assistant psychologists, service managers and PMVA training staff.
Exclusion criteria
Exclusion criteria: 1. Learning disabilities services, later life mental health services and child and adolescent mental health services 2. Student nurses
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Feasibility: recruitment and retention rates, intervention uptake and engagement rates, full and partial completion rates for the proposed outcome measures and variability and potential floor and ceiling effects in these outcomes 2. Adverse events (AEs), reported at regular intervals to the steering committee | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 09/09/2019: Staff-reported outcomes: 1. Conflict and containment: The PCC-SR, a validated measure of conflict and containment rates, will be completed by the nurse-in-charge at the end of every shift. The PCC-SR will be completed for each the 10 participating wards, throughout the full 24 weeks of data collection (8 weeks pre-training implementation, 8 weeks implementation and 8 weeks post-training implementation). 2. De-escalation performance: assessed immediately pre-and-post-training. Each consenting participant will be video-recorded pre-and-post training completing a standardised role play. Each recording will be coded by researchers to identify whether it was recorded pre or post-training. Recordings will be sent to independent external raters who will be blinded to pre-or-post-training designation and who will rate performance using the De-escalating Aggressive Behaviour Scale (EM-DABS), a validated observer-rated measure of de-escalation performance. 3. Training acceptability: assessed via the Training Acceptability Rating Scale (TARS) which measures knowledge, confidence, applicability, quality and satisfaction of training. The TARS will be completed by all consenting participants at a single time-point immediately post-training. 4. Capabilities, opportunities, and motivations to use de-escalation techniques: a 7-item COM-B questionnaire assesses physical capability, psychological capability, physical opportunity, social opportunity, conscious motivation, automatic motivation as well as behaviour in relation to using de-escalation techniques. This measure will be completed by staff at four time-points: Week 1 and 8 of the pre-implementation and Week 16 and 24 of the post-implementation data collection period. 5. Attitudes to containment: 11 items rated on a scale that rates staff perceptions of the acceptability of containment methods.This measure will be completed by staff at four time-points: Week 1 and 8 of the | — |
Countries
England, United Kingdom
Outcome results
None listed