Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research

Background: Safewards is a complex psychosocial intervention designed to reduce conflict and containment on inpatient mental health units. There is mounting international evidence of the effectiveness and acceptability of Safewards. However, a significant challenge exists in promising interventions,...

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Autores principales:	Justine Fletcher, Lisa Brophy, Jane Pirkis, Bridget Hamilton
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	Safewards implementation science (MeSH) inpatient mental health services restrictive practices seclusion and restraint reduction Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/243d30279e5e4482adca708dffb271f6
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spelling	oai:doaj.org-article:243d30279e5e4482adca708dffb271f62021-11-04T05:34:12ZContextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research1664-064010.3389/fpsyt.2021.733272https://doaj.org/article/243d30279e5e4482adca708dffb271f62021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.733272/fullhttps://doaj.org/toc/1664-0640Background: Safewards is a complex psychosocial intervention designed to reduce conflict and containment on inpatient mental health units. There is mounting international evidence of the effectiveness and acceptability of Safewards. However, a significant challenge exists in promising interventions, such as Safewards, being translated into routine practice. The Consolidated Framework for Implementation Research (CFIR) provides a framework through which to understand implementation in complex health service environments. The aim was to inform more effective implementation of Safewards using the CFIR domains and constructs, capitalizing on developing an understanding of variations across wards.Method: Seven Safewards Leads completed the Training and Implementation Diary for 18 wards that opted in to a trial of Safewards. Fidelity Checklist scores were used to categorize low, medium and high implementers of Safewards at the end of the 12-week implementation period.Results: Qualitative data from the diaries were analyzed thematically and coded according to the five CFIR domains which included 39 constructs. Twenty-six constructs across the five domains were highlighted within the data to have acted as a barrier or enabler. Further analysis revealed that six constructs distinguished between low, medium, and high implementing wards.Discussion: Our findings suggest that for implementation of Safewards to succeed, particular attention needs to be paid to engagement of key staff including managers, making training a priority for all ward staff, adequate planning of the process of implementation and creating an environment on each inpatient unit that prioritize and enables Safewards interventions to be undertaken by staff regularly.Justine FletcherLisa BrophyJane PirkisBridget HamiltonFrontiers Media S.A.articleSafewardsimplementation science (MeSH)inpatient mental health servicesrestrictive practicesseclusion and restraint reductionPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Safewards implementation science (MeSH) inpatient mental health services restrictive practices seclusion and restraint reduction Psychiatry RC435-571
spellingShingle	Safewards implementation science (MeSH) inpatient mental health services restrictive practices seclusion and restraint reduction Psychiatry RC435-571 Justine Fletcher Lisa Brophy Jane Pirkis Bridget Hamilton Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research
description	Background: Safewards is a complex psychosocial intervention designed to reduce conflict and containment on inpatient mental health units. There is mounting international evidence of the effectiveness and acceptability of Safewards. However, a significant challenge exists in promising interventions, such as Safewards, being translated into routine practice. The Consolidated Framework for Implementation Research (CFIR) provides a framework through which to understand implementation in complex health service environments. The aim was to inform more effective implementation of Safewards using the CFIR domains and constructs, capitalizing on developing an understanding of variations across wards.Method: Seven Safewards Leads completed the Training and Implementation Diary for 18 wards that opted in to a trial of Safewards. Fidelity Checklist scores were used to categorize low, medium and high implementers of Safewards at the end of the 12-week implementation period.Results: Qualitative data from the diaries were analyzed thematically and coded according to the five CFIR domains which included 39 constructs. Twenty-six constructs across the five domains were highlighted within the data to have acted as a barrier or enabler. Further analysis revealed that six constructs distinguished between low, medium, and high implementing wards.Discussion: Our findings suggest that for implementation of Safewards to succeed, particular attention needs to be paid to engagement of key staff including managers, making training a priority for all ward staff, adequate planning of the process of implementation and creating an environment on each inpatient unit that prioritize and enables Safewards interventions to be undertaken by staff regularly.
format	article
author	Justine Fletcher Lisa Brophy Jane Pirkis Bridget Hamilton
author_facet	Justine Fletcher Lisa Brophy Jane Pirkis Bridget Hamilton
author_sort	Justine Fletcher
title	Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research
title_short	Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research
title_full	Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research
title_fullStr	Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research
title_full_unstemmed	Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research
title_sort	contextual barriers and enablers to safewards implementation in victoria, australia: application of the consolidated framework for implementation research
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/243d30279e5e4482adca708dffb271f6
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Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research

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