The Environment of De-Escalation & Seclusion EnDoRSe Study
Research type
Research Study
Full title
The Impact of Environment on the Use of De-Escalation and Seclusion on Psychiatric Wards (The EnDoRSe Study)
IRAS ID
252792
Contact name
Hamid Alhaj
Contact email
Sponsor organisation
Sheffield Health and Social Care NHS Foundation Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
How do environmental factors contribute to increases and decreases in use of seclusion and de-escalation in psychiatric inpatient settings, and the experiences of patients and staff?
Restrictive interventions (RIs) such as seclusion rooms and restraint are used in inpatient settings to manage violence/aggression and prevent harm to the patient or others. Questions have been raised about the therapeutic benefit of RIs, which can be experienced by patients as traumatic. A number of RI reduction programmes have been developed. For example, Safewards has been shown to reduce RIs by approximately 26%. However, little evidence exists on how effective the different parts of RI reduction programmes are. Additionally, little is known about how the inpatient environment affects the use and experience of RIs.
The current research investigates use of RIs, including identification of the contributory factors associated with increases/decreases in use. This feasibility study will form the basis of a national study of seclusion/de-escalation environments which aims to produce evidence-based guidelines to better inform the use of RIs.
Staff and patients will take photographs of hospital spaces and discuss these in interviews to gain understanding of the factors contributing to their experiences of the hospital environment and the experience of RIs. Data on all RIs/de-escalation requiring the use of a specific de-escalation space will be collected from adult acute psychiatric wards and psychiatric intensive care (PICU) within SHSC between January and May 2019. Information on environmental, staff and patient factors will be collected via questionnaires/ward records.
Participants will be inpatients from the acute psychiatric wards or PICU within SHSC; be aged 18 years and over and have experienced at least one RI/de-escalation requiring the use of a specific de-escalation space (excluding patients with a diagnosis of moderate/severe learning disability). Staff employed on the previously mentioned wards are also invited to participate.
REC name
Yorkshire & The Humber - Sheffield Research Ethics Committee
REC reference
19/YH/0006
Date of REC Opinion
8 Mar 2019
REC opinion
Further Information Favourable Opinion