EFEKTIVITAS MODEL SAFEWARDS DALAM MENGURANGI KEKERASAN DAN KONFLIK DI LINGKUNGAN UNIT PERAWATAN PSIKIATRI

Authors

  • Junita Lasma Mahasiswa Program Studi Magister Keperawatan STIK Sint Carolus Jakarta
  • Emiliana Tarigan Mahasiswa Program Studi Magister Keperawatan STIK Sint Carolus Jakarta

DOI:

https://doi.org/10.31004/prepotif.v9i1.43397

Keywords:

Safewards, psychiatric inpatient care, conflict, restraint.

Abstract

Konflik dan penggunaan tindakan koersif di bangsal psikiatri merupakan tantangan besar yang dapat berdampak negatif pada pasien dan staf. Model Safewards hadir sebagai pendekatan berbasis bukti untuk mengatasi masalah ini melalui intervensi yang terstruktur. Studi ini bertujuan untuk mengevaluasi efektivitas model Safewards dalam menciptakan lingkungan perawatan yang lebih aman dan harmonis. Penelitian ini menggunakan metode literature review dengan menganalisis artikel dari basis data terpercaya seperti Scopus, ScienceDirect, dan PubMed. Artikel yang dipilih memenuhi kriteria inklusi, yaitu berfokus pada implementasi model Safewards di konteks psikiatri dan unit kesehatan mental lainnya. Analisis dilakukan dengan alat penilaian kritis seperti CASP dan JBI. Hasil menunjukkan bahwa penerapan model Safewards mampu mengurangi konflik serta tindakan koersif, termasuk penahanan fisik dan sedasi paksa. Selain itu, model ini juga terbukti meningkatkan hubungan terapeutik antara staf dan pasien, menciptakan suasana yang lebih kondusif di bangsal. Diskusi: Keberhasilan implementasi model Safewards dipengaruhi oleh berbagai faktor, seperti dukungan manajemen, pelatihan yang memadai, dan adaptasi dengan konteks lokal. Hambatan yang dihadapi meliputi pelatihan staf dan dukungan manajemen. Model Safewards telah terbukti efektif dalam meningkatkan kualitas lingkungan perawatan psikiatri dengan mengurangi konflik dan tindakan koersif. Dukungan berkelanjutan dan pelatihan intensif diperlukan untuk memastikan penerapan yang optimal di berbagai layanan kesehatan mental.  

References

Asikainen, J., Louheranta, O., Vehviläinen-Julkunen, K., & Repo-Tiihonen, E. (2020). Use of coercion prevention tools in Finnish psychiatric wards. Archives of Psychiatric Nursing, 34(5), 412–420. https://doi.org/10.1016/j.apnu.2020.07.013

Baumgardt, J., Jäckel, D., Helber-Böhlen, H., Morgenstern, K., Voigt, A., Schöppe, E., McCutcheon, A.-K., Velasquez Lecca, E. E., Löhr, M., Schulz, M., Bechdolf, A., & Weinmann, S. (2020). Making Psychiatric Wards More Peaceful Places: Evaluating the Implementation of the Safewards Model in Acute Psychiatry Using a Pre–Post Mixed-Method Study Design. In Making Psychiatric Wards More Peaceful Places: Evaluating the Implementation of the Safewards Model in Acute Psychiatry Using a Pre–Post Mixed-Method Study Design. SAGE Publications Ltd. https://doi.org/10.4135/9781529726411

Bowers, L. (2014). Safewards: A new model of conflict and containment on psychiatric wards. Journal of Psychiatric and Mental Health Nursing, 21(6), 499–508. https://doi.org/10.1111/jpm.12129

Bowers, L., James, K., Quirk, A., Simpson, A., Stewart, D., & Hodsoll, J. (2015). Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial. International Journal of Nursing Studies, 52(9), 1412–1422. https://doi.org/10.1016/j.ijnurstu.2015.05.001

Dawson, S., Oster, C., Page, M., & George, S. (2024). Exploring the Safewards Programme to Reduce Restrictive Practices in Residential Aged Care: Protocol for a Pilot and Feasibility Study. Health Expectations, 27(5). https://doi.org/10.1111/hex.70037

Dickens, G. L., Tabvuma, T., & Frost, S. A. (2020). Safewards: Changes in conflict, containment, and violence prevention climate during implementation. International Journal of Mental Health Nursing, 29(6), 1230–1240. https://doi.org/10.1111/inm.12762

Fletcher, J., Brophy, L., Pirkis, J., & Hamilton, B. (2021). Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.733272

Fletcher, J., Hamilton, B., Kinner, S. A., & Brophy, L. (2019). Safewards impact in inpatient mental health units in Victoria, Australia: Staff perspectives. Frontiers in Psychiatry, 10(JULY). https://doi.org/10.3389/fpsyt.2019.00462

Hamilton, J., Cole, A., Bostwick, R., & Ngune, I. (2024). Staff Perceptions on the Effectiveness of GRiP-S, a New Approach to Clinical Supervision Incorporating Safewards: An Interpretive Phenomenological Analysis. Issues in Mental Health Nursing, 45(1), 85–95. https://doi.org/10.1080/01612840.2023.2280198

Haugom, E. W., Ruud, T., & Hynnekleiv, T. (2019). Ethical challenges of seclusion in psychiatric inpatient wards: A qualitative study of the experiences of Norwegian mental health professionals. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4727-4

Higgins, N., Meehan, T., Dart, N., Kilshaw, M., & Fawcett, L. (2018). Implementation of the Safewards model in public mental health facilities: A qualitative evaluation of staff perceptions. International Journal of Nursing Studies, 88, 114–120. https://doi.org/10.1016/j.ijnurstu.2018.08.008

Lee, H., Doody, O., & Hennessy, T. (2021). Mental health nurses experience of the introduction and practice of the Safewards model: a qualitative descriptive study. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00554-x

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., Antes, G., Atkins, D., Barbour, V., Barrowman, N., Berlin, J. A., Clark, J., Clarke, M., Cook, D., D’Amico, R., Deeks, J. J., Devereaux, P. J., Dickersin, K., Egger, M., Ernst, E., Gøtzsche, P. C., … Tugwell, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. In PLoS Medicine (Vol. 6, Issue 7). Public Library of Science. https://doi.org/10.1371/journal.pmed.1000097

Mullen, A., Browne, G., Hamilton, B., Skinner, S., & Happell, B. (2022). Safewards: An integrative review of the literature within inpatient and forensic mental health units. In International Journal of Mental Health Nursing (Vol. 31, Issue 5, pp. 1090–1108). John Wiley and Sons Inc. https://doi.org/10.1111/inm.13001

Pelto-Piri, V., Kjellin, L., Backman, G., Carlsson, K., & Björkdahl, A. (2024). Patient responsiveness as a safewards fidelity indicator: a qualitative interview study on an acute psychiatric in-patient ward. BMC Health Services Research, 24(1). https://doi.org/10.1186/s12913-024-11326-z

Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119–2126. https://doi.org/10.11124/JBIES-20-00167

Stensgaard, L., Andersen, M. K., Nordentoft, M., & Hjorthøj, C. (2018). Implementation of the safewards model to reduce the use of coercive measures in adult psychiatric inpatient units: An interrupted time-series analysis. Journal of Psychiatric Research, 105, 147–152. https://doi.org/10.1016/J.JPSYCHIRES.2018.08.026

Downloads

Published

2025-04-18

How to Cite

Lasma, J., & Tarigan, E. (2025). EFEKTIVITAS MODEL SAFEWARDS DALAM MENGURANGI KEKERASAN DAN KONFLIK DI LINGKUNGAN UNIT PERAWATAN PSIKIATRI. PREPOTIF : JURNAL KESEHATAN MASYARAKAT, 9(1), 1656–1670. https://doi.org/10.31004/prepotif.v9i1.43397

Issue

Section

Articles